1. Screw augmentation for spinopelvic fixation in neuromuscular spine deformities: technical note
- Author
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Arnaud Dubory, Aurélien Courvoisier, Houssam Bouloussa, Baptiste Morel, Raphaël Vialle, Manon Bachy, Service de pédiatrie orthopédique [CHU Trousseau], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Santé, Plasticité, Motricité (TIMC-IMAG-SPM), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Centre Hospitalier Universitaire [Grenoble] (CHU), and Service de Radiologie [CHU Trousseau]
- Subjects
Male ,MESH: Neuromuscular Diseases ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,MESH: Postural Balance ,0302 clinical medicine ,Pedicle Screws ,MESH: Postoperative Period ,MESH: Child ,Orthopedics and Sports Medicine ,Postoperative Period ,Prospective Studies ,MESH: Pedicle Screws ,Child ,Postural Balance ,030222 orthopedics ,MESH: Pelvic Bones ,MESH: Scoliosis ,Neuromuscular Diseases ,medicine.anatomical_structure ,surgical procedures, operative ,Scoliosis ,Spinal fusion ,MESH: Sacrum ,Female ,Paraplegia ,musculoskeletal diseases ,Sacrum ,medicine.medical_specialty ,MESH: Cerebral Palsy ,Adolescent ,Augmentable screw ,MESH: Paraplegia ,Cerebral palsy ,MESH: Braces ,03 medical and health sciences ,Pelvic obliquity ,medicine ,Spinopelvic fixation ,MESH: Muscular Dystrophy, Duchenne ,Humans ,Pelvic Bones ,Pelvis ,MESH: Adolescent ,Braces ,MESH: Humans ,business.industry ,Cerebral Palsy ,[SCCO.NEUR]Cognitive science/Neuroscience ,medicine.disease ,equipment and supplies ,MESH: Spinal Fusion ,Sagittal plane ,MESH: Prospective Studies ,MESH: Male ,Surgery ,Muscular Dystrophy, Duchenne ,Bisphenol-a-glycidyl dimethacrylate ,Spinal Fusion ,Neuromuscular scoliosis ,business ,Spastic quadriplegia ,MESH: Female ,030217 neurology & neurosurgery - Abstract
The primary goal of curve correction in neuromuscular patients is to restore coronal and sagittal trunk balance, including the pelvis, to maximize sitting balance. For several years, it has been a common practice to inject polymeric cement into osteoporotic bone through specially designed, perforated pedicle screws in an effort to enhance screw stability. Therefore, we started using the association of a spinopelvic fixation with S1 pedicle screw augmentation, using bisphenol-a-glycidyl dimethacrylate composite resin in neuromuscular patients with pelvic obliquity, technique in neuromuscular patients to improve pedicle screw stability of our pelvic construct. Ten patients undergoing spinopelvic fixation for a neuromuscular spinal deformity were enrolled in the study. Clinical and radiographic data were analyzed and presented. Minimal follow-up took place at 6 months to assess early complications. Five patients were diagnosed with spastic quadriplegia secondary to cerebral palsy, four had Duchenne’s muscular dystrophy, and one had a T5-level traumatic flaccid paraplegia. Preoperative PO ranged from 8° to 34° (mean 19.16°). Postoperative PO ranged from 0° to 6.3° (mean 1.6°). After surgery, all patients returned to a full-time sitting position between days 5 and 12 without the need for additional bracing. No mechanical failure of the construct was noted during follow-up. We used sacral pedicle screw augmentation as a reliable tool to strengthen spinopelvic fixation in neuromuscular scoliosis without increasing the intraoperative morbidity. In our practice, sacral screw augmentation can definitely enhance PO correction obtained by a posterior procedure.
- Published
- 2015
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