Abstract
STUDY DESIGN
Retrospective review of outcome of submuscular rod placement without apical fusion for the treatment of scoliotic deformities in children with severe co morbidities (ASA IV).
METHODS
6 children with progressive scoliosis (2 severe cerebral palsy, 2 congenital cyanotic heart disease, 1 Worster Drought syndrome, 1 Leigh's disease), underwent a serial and limited exposure of the lower and then the upper end of the spine, and insertion of pedicle screws, hooks and clamps. Two submuscularly rods were connected and distracted.
Mean age was 13 years old, the mean preoperatively Cobb angle was 87° and the mean postoperatively Cobb angle was 62°. The mean operation time was 120 min and the peri-operative blood loss was 410 ml. Mean follow up is 15 months.
RESULTS
There were no adverse peri-operative events. We anticipated late implant failure and revisions but to date only one construct has failed and revised without difficulties (clamps to pedicle screws). 1 patient complicated with increased spasms 1 year postoperatively.
The benefits from this procedure were
a) the decreased peri-operative:
blood loss
operation time
respiratory stress
b) the faster patients recovery
c) the significant improvement regarding pain relief and sitting positioning.
CONCLUSION
We believe that this procedure can be offered as a safe and viable alternative in selected patients who present with predicted high peri-operative mortality.
To the best of our knowledge this technique is not described before.
Ethics approval: None
Interest Statement: None
