Spontaneous induced bone fusion in minimally invasive fusionless bipolar fixation in neuromuscular scoliosis: a computed tomography analysis
Article dans une revue avec comité de lecture
Date
2023-05Journal
European Spine JournalAbstract
Purpose
Posterior spinal fusion (PSF) at skeletal maturity is still the gold standard in children with neuromuscular scoliosis (NMS) who underwent fusionless surgery. The aim of this computed tomography (CT) study was to quantify the spontaneous bone fusion at the end of a lengthening program by minimally invasive fusionless bipolar fixation (MIFBF), that could avoid PSF.
Methods
NMS operated on with MIFBF from T1 to the pelvis and at final lengthening program were included. CT was performed at least five years postoperatively. The autofusion was classified as completely or not fused at the facets joint (on both coronal and sagittal plane, right and left side, from T1 to L5), and around the rods (axial plane, right and left side, from T5 to L5). Vertebral body heights were assessed.
Results
Ten patients were included (10.7y ± 2 at initial surgery). Mean Cobb angle was 82 ± 20 preoperatively and 37 ± 13 at last follow-up. CT were performed on average 6.7y ± 1.7 after initial surgery. Mean preoperative and last follow-up thoracic vertebrae height were respectively 13.5 mm ± 1.7 and 17.4 mm ± 1.7 (p < 0.001). 93% facets joints were fused (out of 320 analyzed joints), corresponding to 15/16 vertebral levels. Ossification around the rods was observed in 6.5±2.4 levels out of 13 in the convex side, and 4.2 ± 2.2 in the concave side (p = 0.04).
Conclusions
This first computed quantitative study showed MIFBF in NMS preserved spinal growth, while it induced 93% of facet joints fusion. This could be is an additional argument when questionning the real need for PSF at skeletal maturity.
Files in this item
- Name:
- IBHGC_ESJ_2023_GAUME.pdf
- Size:
- 1.270Mb
- Format:
- Description:
- Spontaneous induced bone fusion ...
- Embargoed until:
- 2023-11-04
Related items
Showing items related by title, author, creator and subject.
-
Article dans une revue avec comité de lectureGAUME, Mathilde; LOISELET, Klervie; CHEKIR, Hedi; LANGLAIS, Tristan; BODDAERT, Nathalie; STRICKER, Sarah; PANNIER, Stéphanie; SKALLI, Wafa; MILADI, Lotfi; VERGARI, Claudio (Springer Science and Business Media LLC, 2023-11)Objectives There are no established criteria for stiffness after fusionless surgery for neuromuscular scoliosis (NMS). As a result, there is no consensus regarding the surgical strategy to propose at long-term follow-up. ...
-
Article dans une revue avec comité de lectureGAUME, Mathilde; KHOURI, Nejib; SKALLI, Wafa; GLORION, Christophe; MILADI, Lotfi; VERGARI, Claudio (Lippincott Williams & Wilkins, 2021)Study Design. A prospective study. Objective. The aim of this study was to report the results of an alternative technique to growing rods (GR) for neuromuscular scoliosis using a minimally invasive fusionless surgery ...
-
Article dans une revue avec comité de lectureGAUME, Mathilde; PERSOHN, Sylvain; GLORION, Christophe; SKALLI, Wafa; MILADI, Lotfi; VERGARI, Claudio (Springer Verlag, 2020)Study design Biomechanical human cadaver study. Objective To determine the three-dimensional intervertebral ranges of motion (ROMs) of intact and hook-instrumented tho- racic spine specimens subjected to physiological ...
-
Article dans une revue avec comité de lectureGrowth-preserving spinal surgery suffer from high complications rate. A recent bipolar instrumentation using two anchoring points (thoracic and pelvic) showed lower rates, but its biomechanical behaviour has not been ...
-
Article dans une revue avec comité de lectureLANGLAIS, Tristan; VERGARI, Claudio; ROUGEREAU, Grégoire; GAUME, Mathilde; GAJNY, Laurent; ABELIN-GENEVOIS, Kariman; BERNARD, Jean-Claude; HU, Zongshan; CHENG, Jack Chun Yiu; CHU, Winnie Chiu Wing; ASSI, Ayman; KARAM, Mohamad; GHANEM, Ismat; BASSANI, Tito; GALBUSERA, Fabio; SCONFIENZA, Luca Maria; BRAYDA-BRUNO, Marco; COURTOIS, Isabelle; EBERMEYER, Eric; VIALLE, Raphaël; DUBOUSSET, Jean; SKALLI, Wafa (2024-02)Introduction Our objective was to assess abnormalities of the odontoid-hip axis (OD-HA) angle in a mild scoliotic population to determine whether screening for malalignment would help predict the distinction between ...