Posterior-only surgical correction with heavy halo-femoral traction for the treatment of severe and rigid congenital scoliosis associated with tethered spinal cord and Type II split cord malformation.

Posterior-only surgical correction with heavy halo-femoral traction for the treatment of severe and rigid congenital scoliosis associated with tethered spinal cord and Type II split cord malformation.:

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Posterior-only surgical correction with heavy halo-femoral traction for the treatment of severe and rigid congenital scoliosis associated with tethered spinal cord and Type II split cord malformation.

World Neurosurg. 2020 Apr 03;:

Authors: Zhang HQ, Deng A, Liu SH, Wang YX, Alonge E

Abstract

OBJECTIVE: To evaluate the safety and efficacy of posterior-only surgical correction with heavy halo-femoral traction for the treatment of severe and rigid congenital scoliosis (SRCS) associated with tethered spinal cord (TSC) and Type II split cord malformation (SCM).

METHODS: 13 patients suffered from SRCS associated with TSC and Type II SCM underwent posterior-only surgical correction with heavy halo-femoral traction. The preoperative mean coronal Cobb angle was 88.87°±12.15°; the mean flexibility was 15.28%±3.88%; the mean angle of thoracic kyphosis (TK) and lumbar lordosis (LL) were 39.63°±18.47° and 56.99°±10.02°, respectively.

RESULTS: The mean duration of surgery was 320±43.64 min and the mean blood loss was 1422.31±457.59 ml. The mean follow-up period was 24.46±7.53 months. After heavy halo-femoral traction, the mean coronal Cobb angle was reduced to 59.14°±8.75°. After posterior-only surgical correction, postoperative mean coronal Cobb angle was further reduced to 33.85°±8.77°. The postoperative mean correction rate was 62.46%±5.04%. The postoperative mean angle of TK and LL were 29.31°±6.75° and 47.79°±3.68°, respectively. At the final follow up, the corrective loss rate of Cobb angle was only 0.69%. There were no significant differences between final follow-up and preoperative Modified Japanese Orthopaedic Association (mJOA) total scores. The Scoliosis Research Society (SRS)-22 total score improved at the final follow-up evaluation compared with the preoperative total score.

CONCLUSIONS: Without prophylactic neurosurgical intervention and spine-shortening osteotomy, posterior-only surgical correction with heavy halo-femoral traction could be safe and effective for the treatment of SRCS associated with TSC and Type II SCM.

PMID: 32251829 [PubMed - as supplied by publisher]