Surgical Correction of Spinal Deformity Using a Unit Rodin Children with Cerebral Palsy

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Abstract
Summary Thirty-one patients with cerebral palsy and neuromuscular scoliosis underwent instrumentation with a unit rod fixed with sublaminar wires and posterior spine fusion. The mean curve measured 79° preoperatively, 19° immediately postoperatively, and 18° at final follow-up of 2.8 years, excluding two patients who died and four who were lost to follow-up after <12 months. The preoperative pelvic obliquity was 25°, which was initially corrected to 3° and remained unchanged at 4° at final follow-up. Twenty-four patients underwent a one-stage posterior fusion, and seven patients underwent both anterior and posterior fusions. Complications included one acute deep-wound infection and one late deep-wound wound infection seeded from the urinary tract. No pseud-arthroses or hardware failures have occurred to date. Seven children with open triradiate cartilages had a posterior spinal fusion only and were followed up to skeletal maturity with a 3° loss of correction of the scoliosis and a 0° loss of correction of pelvic obliquity. Questionnaries filled out by primary caretakers demonstrated that the objective of improving the child's ability to sit more comfortably was accomplished for the majority (65%) of patients. Spinal fusion was recommended for other children by 86% of interviewed caretakers.