The impact of posterior temporary internal distraction on stepwise corrective surgery for extremely severe and rigid scoliosis greater than 130°

Hu, Huimin; Hua, Hui; Zhang, Haiping; Huang, Dageng; Liu, Zhongkai; Zhao, Yuan-Ting; He, Simin; Zhang, Xuefang; He, Baorong; Hao, Dingjun

doi:10.1007/s00586-015-4013-z

Cited by 15 publications

(15 citation statements)

References 66 publications

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“…At 12 to 15 weeks after the initial surgery, patients were submitted to posterior fusion, without the need for three-column osteotomy, achieving final average correction of 64% without death or neurological and pulmonary complications. 18 In our research, the patients submitted to temporary internal distraction (the no traction group) without a minimally invasive technique and only one distraction showed a reduction in the primary curve after this procedure of around 5% and after the final procedure, with a larger number of VCR, around 60%, and a final sagittal Cobb angle correction of 25%.…”

Section: Discussionmentioning

confidence: 60%

“…17 An alternative to the contraindications and limitations of cranial halo traction is temporary internal distraction. 6 In a study 18 that assessed the effect of internal distraction with a minimally invasive technique, performed according to Buchowski et al, 19 with no posterior or anterior release in staged surgery for the treatment of stiff and severe scoliosis, a 49% correction was observed in the primary curve after this procedure, with T5-T12 sagittal imbalance correction of 26%. At 12 to 15 weeks after the initial surgery, patients were submitted to posterior fusion, without the need for three-column osteotomy, achieving final average correction of 64% without death or neurological and pulmonary complications.…”

Section: Discussionmentioning

confidence: 99%

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The Use of Cranial Halo Traction Versus Temporary Internal Distraction in Staged Surgery for Severe Scoliosis: A Comparative Study

et al. 2021

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Objective: To determine which method is more effective – cranial halo traction or temporary internal distraction – in staged surgeries for patients with severe (≥ 100°) and stiff (<25% flexibility) scoliosis. Methods: A sample of 12 patients with traction and 7 patients without traction, operated on between January 2013 and December 2017. The patients’ demographic data, the type of surgery performed, complications, and coronal and sagittal alignment parameters were recorded before surgery and in the final follow-up. The data were processed in SPSS 20.0. Comparisons were made between the means (Student's t-test) and the clinical and procedure-related characteristics (likelihood ratio and Fisher's Exact tests), at a confidence level of 0.05. Results: There were no significant intergroup differences for clinical characteristics, complications or degree of correction. However, more patients in the group submitted to temporary internal distraction required vertebral resection osteotomies during definitive surgery (p<0.05). Conclusions: Based on the results, it was not possible to establish which is the most effective method, but it is suggested that staged traction may be more effective, and safer, particularly when the surgeon is less experienced, during surgery on patients with severe and stiff scoliosis. Level of evidence IV; Vase series.

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Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 99%

The Use of Cranial Halo Traction Versus Temporary Internal Distraction in Staged Surgery for Severe Scoliosis: A Comparative Study

et al. 2021

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“…In addition, because there were only 2–3 hooks in the apical region, the distraction force of the apical region was limited, therefore rigid scoliosis could only be corrected by additional anterior release or traction. With the wide application of pedicle screws, one-stage posterior spinal correction alone can achieve good results in the treatment of severe and rigid scoliosis; however, the incidence of implant failure and pseudoarthrosis has been increasing [ 4 , 23 ]. In order to reduce surgical complications, shorten the hospital stay and enhance the stability of internal fixation, we have been applied apical region correction and global balance with 3 rods as a surgical strategy for severe and rigid scoliosis since 2014.…”

Section: Introductionmentioning

confidence: 99%

“…Severe spinal deformities may lead to dysfunction of the nervous system or cardiopulmonary dysfunction, which in turn affects patients' growth, appearance, and long-term mortality [2]. The treatment of this condition remains challenging [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Apical region correction and global balance: a 3-rods surgical strategy for the treatment of severe and rigid scoliosis

Jiao

Tan

Feng

et al. 2022

BMC Musculoskelet Disord

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Background The treatment of severe and rigid scoliosis is challenging. We developed a surgical strategy for severe and rigid scoliosis since 2014. This study aimed to retrospectively analyze the safety and efficacy of apical region correction and global balance with 3 rods as a surgical strategy for the treatment of severe and rigid scoliosis. Methods A retrospective study was performed for patients with severe and rigid scoliosis who underwent one-stage posterior corrective operation using the apical region correction and global balance with 3 rods surgical strategy between February 2014 and April 2020. The inclusion criteria were as follows: [1] Cobb angle > 90°; [2] flexibility < 30%; [3] a minimum 2-year follow-up. Patients were excluded if they had a history of traction or spinal surgery. Coronal and sagittal parameters, including Cobb angle, flexibility, apex vertebra translation, trunk shift (TS), thoracic kyphosis, lumbar lordosis, and sagittal vertical axis (SVA) were measured preoperatively, postoperatively and at the final follow-up. The Scoliosis Research Society 22-item questionnaire was administered preoperatively and at the final follow-up. During the operation, one slightly-bent short rod was placed into the concave side of apical region and correction was achieved by rod-rotation and distraction. Two pre-bent long rods were placed into both sides of the scoliosis and global balance was improved by leveling the proximal thoracic vertebrae and distal lumbar vertebrae. Results A total of 41 patients were included, with an average age of 20 years (range, 12–49 years) and follow-up of 34 months (range, 24–58 months). Postoperative correction rate was 53% for scoliosis. There were 14 patients with normal kyphosis before surgery, and 28 patients with normal kyphosis at the last follow-up. 88% of the patients (23/26) with preoperative coronal imbalance (TS > 20 mm) restored coronal balance at the final follow-up. 87% of the patients (14/16) with preoperative sagittal imbalance (SVA > 40 mm) restored sagittal balance at the final follow-up. The mean operation time and blood loss were 286 min and 941 mL, respectively. No patients had neurological complications or implant failure. Conclusion The surgical strategy of apical region correction and global balance with 3 rods is a safe and effective alternative for the surgical treatment of severe and rigid scoliosis.

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“…The surgical treatment of severe scoliosis is technically challenging and potentially risky [1][2][3]. Various correction methods, such as posterior instrumentation combined with anterior release [4][5][6], combined anterior and posterior surgical procedures with halo traction [7,8], vertebral column decancellation [9], and combined anterior and posterior instrumentation [10], have been reported to date.…”

Section: Introductionmentioning

confidence: 99%

A novel posterior multiple screws distraction reducer system versus anterior release, posterior internal distraction, and subsequent spinal fusion for severe scoliosis

Feng

Huang

et al. 2021

BMC Musculoskelet Disord

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Purpose We previously reported anterior release, posterior internal distraction, and subsequent spinal fusion (ARPIDF) for the correction of severe scoliosis with a satisfactory correction rate. However, surgical procedures were completed in 2–3 stages. Here we compare Cobb angle of ≥90° in scoliosis correction between a novel posterior multiple screws distraction reducer (MSDR) system and ARPIDF. Methods Thirty-six patients with severe scoliosis treated by MSDR or ARPIDF (n = 18 in both groups). We retrospectively analyzed and compared outcome measures between the two groups over a minimum follow-up duration of 2 years. The following variables were compared between the two groups: age at surgery, sex, etiology, flexibility of the main thoracic curve, number of fused segments and screws, operation time, estimated blood loss, hospitalization time, follow-up duration, various radiological parameters, complication rate, and Scoliosis Research Society-30 score. Results There were no significant between-group differences with respect to age, sex, etiology, flexibility of the main thoracic curve, number of fused segments and screws, and follow-up duration. Further, there was no significant difference in terms of preoperative, postoperative, and final follow-up findings of the radiographic data. However, the ARPIDF group had longer operation and hospitalization times and greater blood loss. In the ARPIDF group, 4 patient developed complications (infection, intraoperative neuromonitoring changes, transient dyspnea); none of these events occurred in the MSDR group. Conclusion The use of MSDR helped achieve greater scoliosis correction with a shorter operation time, lower blood loss, and lower complication rate than the use of ARPIDF. MSDR facilitates safer and easier correction of severe scoliosis without increasing surgical risk.

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The impact of posterior temporary internal distraction on stepwise corrective surgery for extremely severe and rigid scoliosis greater than 130°

Abstract: Temporary internal distraction in a two-stage corrective surgery provided patients who had extremely severe and rigid scoliosis, an effective and safe solution for scoliosis without significant complications.

Cited by 15 publications

References 66 publications

The Use of Cranial Halo Traction Versus Temporary Internal Distraction in Staged Surgery for Severe Scoliosis: A Comparative Study

The Use of Cranial Halo Traction Versus Temporary Internal Distraction in Staged Surgery for Severe Scoliosis: A Comparative Study

Apical region correction and global balance: a 3-rods surgical strategy for the treatment of severe and rigid scoliosis

A novel posterior multiple screws distraction reducer system versus anterior release, posterior internal distraction, and subsequent spinal fusion for severe scoliosis

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