Complications of the Luque–Galveston scoliosis correction technique in paediatric cerebral palsy

Nectoux, Éric; Giacomelli, M.-C.; Karger, C.; Herbaux, B.; Clavert, J

doi:10.1016/j.otsr.2010.01.004

Cited by 32 publications

(30 citation statements)

References 15 publications

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“…These results are comparable to those found in literature, with Cobb angle correction rates ranging from 54 to 82% and pelvic obliquity correction rate ranging from 42 to 86.8%, using Luque Galveston or Unit Rod instrumentation [25, 29–32]. …”

Section: Discussionsupporting

confidence: 89%

“…Respiratory complications are a major concern in these patients, occurring in 23.5 to 57% of cases [21, 29, 45]. The analysis of our series found respiratory complications in only 15.6% of the population.…”

Section: Discussionmentioning

confidence: 80%

“…Complication rate after surgical correction of neuromuscular scoliosis is variable according to different authors but remains high [14, 16–21, 24–27, 29]. In these different studies, complication rate ranges from 17 to 74%, Benson et al [21] reporting the highest rate with 17 complications in 24 patients, predominantly infectious and respiratory problems.…”

Section: Discussionmentioning

confidence: 99%

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Experience in Perioperative Management of Patients Undergoing Posterior Spine Fusion for Neuromuscular Scoliosis

Pesenti

Blondel

Peltier

et al. 2016

BioMed Research International

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The objective of this investigation was to determine the outcome of spine fusion for neuromuscular (NM) scoliosis, using Unit Rod technique, with emphasis on complications related to preoperative general health. Between 1997 and 2007, 96 consecutive patients with neuromuscular scoliosis operated on with Unit Rod instrumentation were retrospectively reviewed. The inclusion criteria were diagnosis of NM scoliosis due to cerebral palsy (CP) and muscular dystrophy (DMD). Patient's preoperative general health, weight, and nutrition were collected. Different radiographic and clinical parameters were evaluated. There were 66 CP patients (59 nonwalking) and 30 DMD patients (24 nonwalking). Mean age at surgery was 16.5 years and 13.9 years, respectively. All radiographic measurements improved significantly. Wound infection rate was 16.7% (11% of reoperation rate in CP; 10% in DMD; 3 hardware removal cases). No pelvic fracture due to rod irritation was observed. Unit Rod technique provides good radiographic and clinical outcomes even if this surgery is associated with a high complication rate. It is a quick, simple, and reliable technique. Perioperative management strategy should decrease postoperative complications and increases outcome. A standardized preoperative patient evaluation and preparation including respiratory capacity and nutritional, digestive, and musculoskeletal status are mandatory prior to surgery.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

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Experience in Perioperative Management of Patients Undergoing Posterior Spine Fusion for Neuromuscular Scoliosis

Pesenti

Blondel

Peltier

et al. 2016

BioMed Research International

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“…We investigated the individual studies to discern plausible explanations for the observed results. Nectoux et al [64] suggest that their spastic and non-ambulatory CP patients had increased risk of fractures with instrumented surgery. Phillips et al [46] reported implant breakages with two types of spino-pelvic anchorages.…”

Section: Implant-related Complicationsmentioning

confidence: 99%

Prevalence of complications in neuromuscular scoliosis surgery: a literature meta-analysis from the past 15 years

et al. 2012

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Purpose Our objectives were primarily to review the published literature on complications in neuromuscular scoliosis (NMS) surgery and secondarily, by means of a meta-analysis, to determine the overall pooled rates (PR) of various complications associated with NMS surgery. Methods PubMed and Embase databases were searched for studies reporting the outcomes and complications of NMS surgery, published from 1997 to May 2011. We focused on NMS as defined by the Scoliosis Research Society's classification. We measured the pooled estimate of the overall complication rates (PR) using a random effects meta-analytic model. This model considers both intra-and inter-study variation in calculating PR. Results Systematic review and meta-analysis were performed for 68 cohort and case-control studies with a total of 15,218 NMS patients. Pulmonary complications were the most reported (PR = 22.71 %) followed by implant complications (PR = 12.51 %), infections (PR = 10.91 %), neurological complications (PR = 3.01 %) and pseudoarthrosis (PR = 1.88 %). Revision, removal and extension of implant had highest PR (7.87 %) followed by malplacement of the pedicle screws (4.81 %). Rates of individual studies have moderate to high variability. The studies were heterogeneous in methodology and outcome types, which are plausible explanations for the variability; sensitivity analysis with respect to age at surgery, sample size, publication year and diagnosis could also partly explain this variability. In regard to surgical complications affiliated with various surgical techniques in NMS, the level of evidence of published literature ranges between 2? to 2-; the subsequent recommendations are level C. Conclusion NMS patients have diverse and high complication rates after scoliosis surgery. High PRs of complications warrant more attention from the surgical community. Although the PR of all complications are affected by heterogeneity, they nevertheless provide valuable insights into the impact of methodological settings (sample size), patient characteristics (age at surgery), and continual advances in patient care on complication rates.

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“…Unit rods are additionally pre-shaped in three dimensions with kyphosis, lordosis, and pelvic portions to simplify their insertion. The correction of pelvic obliquity associated with this implant ranges from 57.8 % to 86 % at longest follow-up in retrospective series with pseudarthrosis affecting 0 to 5.9 % of patients [29,40,61,[64][65][66].…”

Section: Galveston Techniquementioning

confidence: 99%

Pelvic fixation for neuromuscular scoliosis deformity correction

Dayer¹,

Ouellet

Saran

2012

Curr Rev Musculoskelet Med

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Pelvic fixation is most frequently indicated in the pediatric population for the treatment of neuromuscular scoliosis with significant pelvic obliquity. Neuromuscular scoliosis surgery is associated with a high risk of complications, and this is further increased by extension of fusion to the sacrum. Numerous techniques have been described for pelvic fixation associated with a long spine fusion each with its own set of specific benefits and risks. This article reviews the contemporary surgical techniques of pelvic fixation used to extend a spine fusion to the sacrum and pelvis focusing on the management of neuromuscular scoliosis, including their biomechanical rationale, results, and complications.

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Complications of the Luque–Galveston scoliosis correction technique in paediatric cerebral palsy

Abstract: Level IV retrospective therapeutic study.

Cited by 32 publications

References 15 publications

Experience in Perioperative Management of Patients Undergoing Posterior Spine Fusion for Neuromuscular Scoliosis

Experience in Perioperative Management of Patients Undergoing Posterior Spine Fusion for Neuromuscular Scoliosis

Prevalence of complications in neuromuscular scoliosis surgery: a literature meta-analysis from the past 15 years

Pelvic fixation for neuromuscular scoliosis deformity correction

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