Minimally invasive fusionless surgery for neuromuscular scoliosis

 

Spinal deformities are common in neuromuscular diseases. Conventional treatment involves bracing, followed by spinal instrumented fusion. Growing rod techniques are increasingly advocated but have a high rate of complications. This retrospective review aimed to report the results of an alternative technique using a minimally invasive fusionless surgery. The originality is based on the progressive correction of the deformities with proximal and distal fixation and on the reliability of the pelvic fixation using ilio-sacral screws on osteoporotic bones. A total of 100 patients with neuromuscular scoliosis underwent the same fusionless surgery extended from T1 to the pelvis. The average age at initial surgery was 11+6y. Diagnoses included cerebral palsy (61), spinal muscular atrophy (22), muscular dystrophy (10), and other neurological etiologies (7). The results demonstrate that this original fusionless technique is safe and effective, preserving spinal and thoracic growth. It provides a significant correction of spinal deformities and pelvic obliquity with a reduced complications rate.

Miladi L, Gaume M, Khouri N, et al. Minimally Invasive Surgery for Neuromuscular Scoliosis: Results and Complications in a Series of one hundred Patients. Spine (Phila Pa 1976). 2018 Feb 6. [Epub ahead of print]