Posterior Spinal Fusion Surgery for Neuromuscular Disease Patients With Severe Scoliosis Whose Cobb Angle was Over 100 Degrees

Patients with neuromuscular diseases usually have progressive neuromuscular scoliosis (NMS), requiring invasive surgery. Some patients present with severe scoliosis at the time of consultation and are difficult to treat. Posterior spinal fusion (PSF) surgery combined with anterior release and pre or intraoperative traction would be effective for severe spinal deformity, but invasive. This study aimed to evaluate the outcomes of PSF only surgery for patients with severe NMS with Cobb angle >100 °. Thirty NMS patients (13 boys and 17 girls; mean age 13.8 years) who underwent PSF only surgery for scoliosis with Cobb angle >100 ° were included. We reviewed the lower instrumented vertebra (LIV), duration of surgery, blood loss, perioperative complications, preoperative clinical findings, and radiographic findings including Cobb angle and pelvic obliquity (PO) in the sitting position pre and postoperatively. The correction rate and correction loss of the Cobb angle and PO were also calculated. The mean duration of surgery was 338 min, intraoperative blood loss was 1,440 mL, preoperative %VC was 34.1%, FEV1.0 (%) was 91.5%, and EF was 66.1%. There were eight cases of perioperative complications. The Cobb angle and PO correction rates were 48.5% and 42.0%, respectively. We divided the patients into two groups: the L5 group, in which the LIV was L5, and the pelvis group, in which the LIV was the pelvis. The duration of surgery and PO correction rate in the pelvis group was significantly higher than that of the L5 group. Patients with severe NMS demonstrated severe preoperative restrictive ventilatory impairments. PSF only surgery for severe NMS showed satisfactory outcomes, although highly invasive. Instrumentation and fusion to the pelvis for severe scoliosis in patients with NMS showed good PO correction and low correction loss of Cobb angle and PO, but a longer duration of surgery..

Medienart:	Preprint

Erscheinungsjahr:	2023
Erschienen:	2023

Enthalten in:	Preprints.org - (2023) vom: 12. Juni Zur Gesamtaufnahme - year:2023

Sprache:	Englisch

Beteiligte Personen:

Miyagi, Masayuki [VerfasserIn] Saito, Wataru [VerfasserIn] Mimura, Yusuke [VerfasserIn] Nakazawa, Toshiyuki [VerfasserIn] Imura, Takayuki [VerfasserIn] Shirasawa, Eiki [VerfasserIn] Uchida, Kentaro [VerfasserIn] Ikeda, Shinsuke [VerfasserIn] Kuroda, Akiyoshi [VerfasserIn] Inoue, Sho [VerfasserIn] Yokozeki, Yuji [VerfasserIn] Tanaka, Yoshihide [VerfasserIn] Akazawa, Tsutomu [VerfasserIn] Takaso, Masashi [VerfasserIn] Inoue, Gen [VerfasserIn]

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doi:	10.20944/preprints202305.0654.v1

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PPN (Katalog-ID):	preprintsorg039577090