The correction of pelvic obliquity in patients with cerebral palsy and neuromuscular scoliosis: is there a benefit of anterior release prior to posterior spinal arthrodesis?
Abstract
A retrospective study of 61 patients with cerebral palsy (CP) and neuromuscular scoliosis treated by either a combined anterior-posterior spinal arthrodesis or a posterior-only arthrodesis with the unit rod. Compare coronal and sagittal plane radiographic outcomes in patients undergoing either a combined anterior-posterior spinal fusion (PSF) or a posterior-only fusion with the unit rod for neuromuscular scoliosis in patients with CP. Although an anterior release before posterior spinal arthrodesis is commonly done for larger and stiffer neuromuscular curves, it is unclear whether or not an all-posterior construct produces similar correction in pelvic obliquity as that seen with an anterior-posterior spinal fusion. Sixty-one consecutive children with CP and scoliosis were treated at a single institution between 1991 and 2003 with PSF using the unit rod with an anterior release (group A: 19 patients; average = 14.4 years) or without an anterior release (group B: 42 patients; average = 13.7 years). Side-bending, AP, and lateral radiographs were used to assess various sagittal and coronal plane parameters at baseline, after surgery, and at 2 years. RESULTS.: Before surgery, group A had larger major curves (91 degrees A vs. 72 degr...Continue Reading
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