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Web End = Surgical correction of scoliosis in patients with severe cerebral palsy
Klaas Beckmann1 Tobias Lange1 Georg Gosheger1 Albert Schulze Bvingloh1
Matthias Borowski2 Viola Bullmann3 Ulf Liljenqvist4 Tobias L. Schulte1
Received: 18 January 2015 / Revised: 1 July 2015 / Accepted: 1 July 2015 / Published online: 9 July 2015 Springer-Verlag Berlin Heidelberg 2015
AbstractIntroduction There is a lack of data in the literature on surgical correction of severe neuromuscular scoliosis in patients with serious extent of cerebral palsy. The purpose of this retrospective cohort study was to analyze the radiological and clinical results after posterior-only instrumentation (group P) and combined anteriorposterior instrumentation (group AP) in severe scoliosis in patients with Gross Motor Function Classication System grades IV and V.
Materials and methods All eligible patients who underwent surgery in one institution between 1997 and 2012 were analyzed, and charts, surgical reports, and radio-graphs were evaluated with a minimum follow-up period of 2 years.
Results Fifty-seven patients were included (35 in group P, 22 in group AP), with a median follow-up period of4.1 years. The preoperative mean Cobb angles were 84 (34 % exibility) in group P and 109 (27 % exibility) in group AP. In group P, the Cobb angle was 39 (54 % correction) at discharge and 43 at the nal follow-up, while in group AP the gures were 54 (50 % correction)
at discharge and 56 at the nal follow-up. Major complications occurred in 23 vs. 46 % of the patients, respectively. Preoperative curve exibility was an important predictor for relative curve correction, independently of the type of surgery.
Conclusion Posterior-only surgery appears to lead to comparable radiological results, with shorter operating times and shorter intensive-care unit and hospital stays than combined surgery. The duration of surgery was a relevant predictor for complications.
Keywords Neuromuscular scoliosis Cerebral palsy
Surgery Posterior instrumentation Combined
instrumentation Outcome
Introduction
Cerebral palsy (CP) is a nonprogressive form of encephalopathy caused by damage to motor control centers in the immature brain....