Neuromonitoring Changes Are Common and Reversible With Temporary Internal Distraction for Severe Scoliosis
Study Design Retrospective review of consecutive cases. Objective To examine the neurologic implications of applying intraoperative distraction to large curves. Summary Of Background Data Temporary rods provide internal distraction during correction of severe scoliosis and may be an alternative to p...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Skaggs, David L. [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2014 |
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| Schlagwörter: |
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| Anmerkung: |
© Scoliosis Research Society 2014 |
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| Übergeordnetes Werk: |
Enthalten in: Spine deformity - Amsterdam [u.a.] : Elsevier, 2013, 2(2014), 1 vom: Jan., Seite 61-69 |
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| Übergeordnetes Werk: |
volume:2 ; year:2014 ; number:1 ; month:01 ; pages:61-69 |
| Links: |
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| DOI / URN: |
10.1016/j.jspd.2013.09.009 |
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SPR038867346 |
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| 245 | 1 | 0 | |a Neuromonitoring Changes Are Common and Reversible With Temporary Internal Distraction for Severe Scoliosis |
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| 520 | |a Study Design Retrospective review of consecutive cases. Objective To examine the neurologic implications of applying intraoperative distraction to large curves. Summary Of Background Data Temporary rods provide internal distraction during correction of severe scoliosis and may be an alternative to prolonged halo traction or vertebral column resection. Methods A single surgeon’s consecutive experience with posterior-only spinal fusion with temporary distraction rods was reviewed retrospectively. Inclusion criteria were long posterior-only spinal fusion (10 or more levels) for severe scoliosis (major Cobb angle 80° or greater), treated with temporary internal distraction. Records were reviewed for age, gender, diagnosis, intraoperative course, and complications. Radiographs were reviewed for Cobb angles, T1eS1 length, and space available for each lung. Methods Twenty-two patients with a mean age of 14 years and a mean of 15 levels fused (range, 10–18 levels) were included. The mean preoperative coronal Cobb angle was 113° (range, 83°–144°), and a mean correction of 62° (54%) was achieved. There was a mean T1eS1 increase of 8.4 cm (range, 2.4–14 cm). Nine patients had 2-stage procedures separated by a mean of 7 days. Thirteen patients had a single procedure. Of 22 patients, 9 (41%) had intraoperative neuromonitoring changes. All neuromonitoring changes were reversed after releasing distraction on the temporary rod, except in 1 case. No patient had a clinical neurologic deficit. Conclusions Use of temporary distraction rods for severe scoliosis produces curve correction while providing a mean increase in T1eS1 height of 8 cm. Most steps in this surgery are reversible. Neuromonitoring changes are common, but they are reversible with release of some distraction. Neuromonitoring changes did not affect the final magnitude of correction, and there were no clinical neurologic deficits. We recommend that this procedure be performed only with good neuromonitoring. | ||
| 650 | 4 | |a Temporary internal distraction |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Severe scoliosis |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Neuromonitoring |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Temporary rods |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Deformity correction |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Lee, Christopher |4 aut | |
| 700 | 1 | |a Myung, Karen S. |4 aut | |
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10.1016/j.jspd.2013.09.009 doi (DE-627)SPR038867346 (SPR)j.jspd.2013.09.009-e DE-627 ger DE-627 rakwb eng Skaggs, David L. verfasserin aut Neuromonitoring Changes Are Common and Reversible With Temporary Internal Distraction for Severe Scoliosis 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Scoliosis Research Society 2014 Study Design Retrospective review of consecutive cases. Objective To examine the neurologic implications of applying intraoperative distraction to large curves. Summary Of Background Data Temporary rods provide internal distraction during correction of severe scoliosis and may be an alternative to prolonged halo traction or vertebral column resection. Methods A single surgeon’s consecutive experience with posterior-only spinal fusion with temporary distraction rods was reviewed retrospectively. Inclusion criteria were long posterior-only spinal fusion (10 or more levels) for severe scoliosis (major Cobb angle 80° or greater), treated with temporary internal distraction. Records were reviewed for age, gender, diagnosis, intraoperative course, and complications. Radiographs were reviewed for Cobb angles, T1eS1 length, and space available for each lung. Methods Twenty-two patients with a mean age of 14 years and a mean of 15 levels fused (range, 10–18 levels) were included. The mean preoperative coronal Cobb angle was 113° (range, 83°–144°), and a mean correction of 62° (54%) was achieved. There was a mean T1eS1 increase of 8.4 cm (range, 2.4–14 cm). Nine patients had 2-stage procedures separated by a mean of 7 days. Thirteen patients had a single procedure. Of 22 patients, 9 (41%) had intraoperative neuromonitoring changes. All neuromonitoring changes were reversed after releasing distraction on the temporary rod, except in 1 case. No patient had a clinical neurologic deficit. Conclusions Use of temporary distraction rods for severe scoliosis produces curve correction while providing a mean increase in T1eS1 height of 8 cm. Most steps in this surgery are reversible. Neuromonitoring changes are common, but they are reversible with release of some distraction. Neuromonitoring changes did not affect the final magnitude of correction, and there were no clinical neurologic deficits. We recommend that this procedure be performed only with good neuromonitoring. Temporary internal distraction (dpeaa)DE-He213 Severe scoliosis (dpeaa)DE-He213 Neuromonitoring (dpeaa)DE-He213 Temporary rods (dpeaa)DE-He213 Deformity correction (dpeaa)DE-He213 Lee, Christopher aut Myung, Karen S. aut Enthalten in Spine deformity Amsterdam [u.a.] : Elsevier, 2013 2(2014), 1 vom: Jan., Seite 61-69 (DE-627)747142815 (DE-600)2717704-X 2212-1358 nnns volume:2 year:2014 number:1 month:01 pages:61-69 https://dx.doi.org/10.1016/j.jspd.2013.09.009 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_74 GBV_ILN_647 GBV_ILN_702 GBV_ILN_2004 GBV_ILN_2190 GBV_ILN_2336 AR 2 2014 1 01 61-69 |
| spelling |
10.1016/j.jspd.2013.09.009 doi (DE-627)SPR038867346 (SPR)j.jspd.2013.09.009-e DE-627 ger DE-627 rakwb eng Skaggs, David L. verfasserin aut Neuromonitoring Changes Are Common and Reversible With Temporary Internal Distraction for Severe Scoliosis 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Scoliosis Research Society 2014 Study Design Retrospective review of consecutive cases. Objective To examine the neurologic implications of applying intraoperative distraction to large curves. Summary Of Background Data Temporary rods provide internal distraction during correction of severe scoliosis and may be an alternative to prolonged halo traction or vertebral column resection. Methods A single surgeon’s consecutive experience with posterior-only spinal fusion with temporary distraction rods was reviewed retrospectively. Inclusion criteria were long posterior-only spinal fusion (10 or more levels) for severe scoliosis (major Cobb angle 80° or greater), treated with temporary internal distraction. Records were reviewed for age, gender, diagnosis, intraoperative course, and complications. Radiographs were reviewed for Cobb angles, T1eS1 length, and space available for each lung. Methods Twenty-two patients with a mean age of 14 years and a mean of 15 levels fused (range, 10–18 levels) were included. The mean preoperative coronal Cobb angle was 113° (range, 83°–144°), and a mean correction of 62° (54%) was achieved. There was a mean T1eS1 increase of 8.4 cm (range, 2.4–14 cm). Nine patients had 2-stage procedures separated by a mean of 7 days. Thirteen patients had a single procedure. Of 22 patients, 9 (41%) had intraoperative neuromonitoring changes. All neuromonitoring changes were reversed after releasing distraction on the temporary rod, except in 1 case. No patient had a clinical neurologic deficit. Conclusions Use of temporary distraction rods for severe scoliosis produces curve correction while providing a mean increase in T1eS1 height of 8 cm. Most steps in this surgery are reversible. Neuromonitoring changes are common, but they are reversible with release of some distraction. Neuromonitoring changes did not affect the final magnitude of correction, and there were no clinical neurologic deficits. We recommend that this procedure be performed only with good neuromonitoring. Temporary internal distraction (dpeaa)DE-He213 Severe scoliosis (dpeaa)DE-He213 Neuromonitoring (dpeaa)DE-He213 Temporary rods (dpeaa)DE-He213 Deformity correction (dpeaa)DE-He213 Lee, Christopher aut Myung, Karen S. aut Enthalten in Spine deformity Amsterdam [u.a.] : Elsevier, 2013 2(2014), 1 vom: Jan., Seite 61-69 (DE-627)747142815 (DE-600)2717704-X 2212-1358 nnns volume:2 year:2014 number:1 month:01 pages:61-69 https://dx.doi.org/10.1016/j.jspd.2013.09.009 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_74 GBV_ILN_647 GBV_ILN_702 GBV_ILN_2004 GBV_ILN_2190 GBV_ILN_2336 AR 2 2014 1 01 61-69 |
| allfields_unstemmed |
10.1016/j.jspd.2013.09.009 doi (DE-627)SPR038867346 (SPR)j.jspd.2013.09.009-e DE-627 ger DE-627 rakwb eng Skaggs, David L. verfasserin aut Neuromonitoring Changes Are Common and Reversible With Temporary Internal Distraction for Severe Scoliosis 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Scoliosis Research Society 2014 Study Design Retrospective review of consecutive cases. Objective To examine the neurologic implications of applying intraoperative distraction to large curves. Summary Of Background Data Temporary rods provide internal distraction during correction of severe scoliosis and may be an alternative to prolonged halo traction or vertebral column resection. Methods A single surgeon’s consecutive experience with posterior-only spinal fusion with temporary distraction rods was reviewed retrospectively. Inclusion criteria were long posterior-only spinal fusion (10 or more levels) for severe scoliosis (major Cobb angle 80° or greater), treated with temporary internal distraction. Records were reviewed for age, gender, diagnosis, intraoperative course, and complications. Radiographs were reviewed for Cobb angles, T1eS1 length, and space available for each lung. Methods Twenty-two patients with a mean age of 14 years and a mean of 15 levels fused (range, 10–18 levels) were included. The mean preoperative coronal Cobb angle was 113° (range, 83°–144°), and a mean correction of 62° (54%) was achieved. There was a mean T1eS1 increase of 8.4 cm (range, 2.4–14 cm). Nine patients had 2-stage procedures separated by a mean of 7 days. Thirteen patients had a single procedure. Of 22 patients, 9 (41%) had intraoperative neuromonitoring changes. All neuromonitoring changes were reversed after releasing distraction on the temporary rod, except in 1 case. No patient had a clinical neurologic deficit. Conclusions Use of temporary distraction rods for severe scoliosis produces curve correction while providing a mean increase in T1eS1 height of 8 cm. Most steps in this surgery are reversible. Neuromonitoring changes are common, but they are reversible with release of some distraction. Neuromonitoring changes did not affect the final magnitude of correction, and there were no clinical neurologic deficits. We recommend that this procedure be performed only with good neuromonitoring. Temporary internal distraction (dpeaa)DE-He213 Severe scoliosis (dpeaa)DE-He213 Neuromonitoring (dpeaa)DE-He213 Temporary rods (dpeaa)DE-He213 Deformity correction (dpeaa)DE-He213 Lee, Christopher aut Myung, Karen S. aut Enthalten in Spine deformity Amsterdam [u.a.] : Elsevier, 2013 2(2014), 1 vom: Jan., Seite 61-69 (DE-627)747142815 (DE-600)2717704-X 2212-1358 nnns volume:2 year:2014 number:1 month:01 pages:61-69 https://dx.doi.org/10.1016/j.jspd.2013.09.009 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_74 GBV_ILN_647 GBV_ILN_702 GBV_ILN_2004 GBV_ILN_2190 GBV_ILN_2336 AR 2 2014 1 01 61-69 |
| allfieldsGer |
10.1016/j.jspd.2013.09.009 doi (DE-627)SPR038867346 (SPR)j.jspd.2013.09.009-e DE-627 ger DE-627 rakwb eng Skaggs, David L. verfasserin aut Neuromonitoring Changes Are Common and Reversible With Temporary Internal Distraction for Severe Scoliosis 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Scoliosis Research Society 2014 Study Design Retrospective review of consecutive cases. Objective To examine the neurologic implications of applying intraoperative distraction to large curves. Summary Of Background Data Temporary rods provide internal distraction during correction of severe scoliosis and may be an alternative to prolonged halo traction or vertebral column resection. Methods A single surgeon’s consecutive experience with posterior-only spinal fusion with temporary distraction rods was reviewed retrospectively. Inclusion criteria were long posterior-only spinal fusion (10 or more levels) for severe scoliosis (major Cobb angle 80° or greater), treated with temporary internal distraction. Records were reviewed for age, gender, diagnosis, intraoperative course, and complications. Radiographs were reviewed for Cobb angles, T1eS1 length, and space available for each lung. Methods Twenty-two patients with a mean age of 14 years and a mean of 15 levels fused (range, 10–18 levels) were included. The mean preoperative coronal Cobb angle was 113° (range, 83°–144°), and a mean correction of 62° (54%) was achieved. There was a mean T1eS1 increase of 8.4 cm (range, 2.4–14 cm). Nine patients had 2-stage procedures separated by a mean of 7 days. Thirteen patients had a single procedure. Of 22 patients, 9 (41%) had intraoperative neuromonitoring changes. All neuromonitoring changes were reversed after releasing distraction on the temporary rod, except in 1 case. No patient had a clinical neurologic deficit. Conclusions Use of temporary distraction rods for severe scoliosis produces curve correction while providing a mean increase in T1eS1 height of 8 cm. Most steps in this surgery are reversible. Neuromonitoring changes are common, but they are reversible with release of some distraction. Neuromonitoring changes did not affect the final magnitude of correction, and there were no clinical neurologic deficits. We recommend that this procedure be performed only with good neuromonitoring. Temporary internal distraction (dpeaa)DE-He213 Severe scoliosis (dpeaa)DE-He213 Neuromonitoring (dpeaa)DE-He213 Temporary rods (dpeaa)DE-He213 Deformity correction (dpeaa)DE-He213 Lee, Christopher aut Myung, Karen S. aut Enthalten in Spine deformity Amsterdam [u.a.] : Elsevier, 2013 2(2014), 1 vom: Jan., Seite 61-69 (DE-627)747142815 (DE-600)2717704-X 2212-1358 nnns volume:2 year:2014 number:1 month:01 pages:61-69 https://dx.doi.org/10.1016/j.jspd.2013.09.009 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_74 GBV_ILN_647 GBV_ILN_702 GBV_ILN_2004 GBV_ILN_2190 GBV_ILN_2336 AR 2 2014 1 01 61-69 |
| allfieldsSound |
10.1016/j.jspd.2013.09.009 doi (DE-627)SPR038867346 (SPR)j.jspd.2013.09.009-e DE-627 ger DE-627 rakwb eng Skaggs, David L. verfasserin aut Neuromonitoring Changes Are Common and Reversible With Temporary Internal Distraction for Severe Scoliosis 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Scoliosis Research Society 2014 Study Design Retrospective review of consecutive cases. Objective To examine the neurologic implications of applying intraoperative distraction to large curves. Summary Of Background Data Temporary rods provide internal distraction during correction of severe scoliosis and may be an alternative to prolonged halo traction or vertebral column resection. Methods A single surgeon’s consecutive experience with posterior-only spinal fusion with temporary distraction rods was reviewed retrospectively. Inclusion criteria were long posterior-only spinal fusion (10 or more levels) for severe scoliosis (major Cobb angle 80° or greater), treated with temporary internal distraction. Records were reviewed for age, gender, diagnosis, intraoperative course, and complications. Radiographs were reviewed for Cobb angles, T1eS1 length, and space available for each lung. Methods Twenty-two patients with a mean age of 14 years and a mean of 15 levels fused (range, 10–18 levels) were included. The mean preoperative coronal Cobb angle was 113° (range, 83°–144°), and a mean correction of 62° (54%) was achieved. There was a mean T1eS1 increase of 8.4 cm (range, 2.4–14 cm). Nine patients had 2-stage procedures separated by a mean of 7 days. Thirteen patients had a single procedure. Of 22 patients, 9 (41%) had intraoperative neuromonitoring changes. All neuromonitoring changes were reversed after releasing distraction on the temporary rod, except in 1 case. No patient had a clinical neurologic deficit. Conclusions Use of temporary distraction rods for severe scoliosis produces curve correction while providing a mean increase in T1eS1 height of 8 cm. Most steps in this surgery are reversible. Neuromonitoring changes are common, but they are reversible with release of some distraction. Neuromonitoring changes did not affect the final magnitude of correction, and there were no clinical neurologic deficits. We recommend that this procedure be performed only with good neuromonitoring. Temporary internal distraction (dpeaa)DE-He213 Severe scoliosis (dpeaa)DE-He213 Neuromonitoring (dpeaa)DE-He213 Temporary rods (dpeaa)DE-He213 Deformity correction (dpeaa)DE-He213 Lee, Christopher aut Myung, Karen S. aut Enthalten in Spine deformity Amsterdam [u.a.] : Elsevier, 2013 2(2014), 1 vom: Jan., Seite 61-69 (DE-627)747142815 (DE-600)2717704-X 2212-1358 nnns volume:2 year:2014 number:1 month:01 pages:61-69 https://dx.doi.org/10.1016/j.jspd.2013.09.009 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_74 GBV_ILN_647 GBV_ILN_702 GBV_ILN_2004 GBV_ILN_2190 GBV_ILN_2336 AR 2 2014 1 01 61-69 |
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Objective To examine the neurologic implications of applying intraoperative distraction to large curves. Summary Of Background Data Temporary rods provide internal distraction during correction of severe scoliosis and may be an alternative to prolonged halo traction or vertebral column resection. Methods A single surgeon’s consecutive experience with posterior-only spinal fusion with temporary distraction rods was reviewed retrospectively. Inclusion criteria were long posterior-only spinal fusion (10 or more levels) for severe scoliosis (major Cobb angle 80° or greater), treated with temporary internal distraction. Records were reviewed for age, gender, diagnosis, intraoperative course, and complications. Radiographs were reviewed for Cobb angles, T1eS1 length, and space available for each lung. Methods Twenty-two patients with a mean age of 14 years and a mean of 15 levels fused (range, 10–18 levels) were included. The mean preoperative coronal Cobb angle was 113° (range, 83°–144°), and a mean correction of 62° (54%) was achieved. There was a mean T1eS1 increase of 8.4 cm (range, 2.4–14 cm). Nine patients had 2-stage procedures separated by a mean of 7 days. Thirteen patients had a single procedure. Of 22 patients, 9 (41%) had intraoperative neuromonitoring changes. All neuromonitoring changes were reversed after releasing distraction on the temporary rod, except in 1 case. No patient had a clinical neurologic deficit. Conclusions Use of temporary distraction rods for severe scoliosis produces curve correction while providing a mean increase in T1eS1 height of 8 cm. Most steps in this surgery are reversible. Neuromonitoring changes are common, but they are reversible with release of some distraction. Neuromonitoring changes did not affect the final magnitude of correction, and there were no clinical neurologic deficits. 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Neuromonitoring Changes Are Common and Reversible With Temporary Internal Distraction for Severe Scoliosis Temporary internal distraction (dpeaa)DE-He213 Severe scoliosis (dpeaa)DE-He213 Neuromonitoring (dpeaa)DE-He213 Temporary rods (dpeaa)DE-He213 Deformity correction (dpeaa)DE-He213 |
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neuromonitoring changes are common and reversible with temporary internal distraction for severe scoliosis |
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Neuromonitoring Changes Are Common and Reversible With Temporary Internal Distraction for Severe Scoliosis |
| abstract |
Study Design Retrospective review of consecutive cases. Objective To examine the neurologic implications of applying intraoperative distraction to large curves. Summary Of Background Data Temporary rods provide internal distraction during correction of severe scoliosis and may be an alternative to prolonged halo traction or vertebral column resection. Methods A single surgeon’s consecutive experience with posterior-only spinal fusion with temporary distraction rods was reviewed retrospectively. Inclusion criteria were long posterior-only spinal fusion (10 or more levels) for severe scoliosis (major Cobb angle 80° or greater), treated with temporary internal distraction. Records were reviewed for age, gender, diagnosis, intraoperative course, and complications. Radiographs were reviewed for Cobb angles, T1eS1 length, and space available for each lung. Methods Twenty-two patients with a mean age of 14 years and a mean of 15 levels fused (range, 10–18 levels) were included. The mean preoperative coronal Cobb angle was 113° (range, 83°–144°), and a mean correction of 62° (54%) was achieved. There was a mean T1eS1 increase of 8.4 cm (range, 2.4–14 cm). Nine patients had 2-stage procedures separated by a mean of 7 days. Thirteen patients had a single procedure. Of 22 patients, 9 (41%) had intraoperative neuromonitoring changes. All neuromonitoring changes were reversed after releasing distraction on the temporary rod, except in 1 case. No patient had a clinical neurologic deficit. Conclusions Use of temporary distraction rods for severe scoliosis produces curve correction while providing a mean increase in T1eS1 height of 8 cm. Most steps in this surgery are reversible. Neuromonitoring changes are common, but they are reversible with release of some distraction. Neuromonitoring changes did not affect the final magnitude of correction, and there were no clinical neurologic deficits. We recommend that this procedure be performed only with good neuromonitoring. © Scoliosis Research Society 2014 |
| abstractGer |
Study Design Retrospective review of consecutive cases. Objective To examine the neurologic implications of applying intraoperative distraction to large curves. Summary Of Background Data Temporary rods provide internal distraction during correction of severe scoliosis and may be an alternative to prolonged halo traction or vertebral column resection. Methods A single surgeon’s consecutive experience with posterior-only spinal fusion with temporary distraction rods was reviewed retrospectively. Inclusion criteria were long posterior-only spinal fusion (10 or more levels) for severe scoliosis (major Cobb angle 80° or greater), treated with temporary internal distraction. Records were reviewed for age, gender, diagnosis, intraoperative course, and complications. Radiographs were reviewed for Cobb angles, T1eS1 length, and space available for each lung. Methods Twenty-two patients with a mean age of 14 years and a mean of 15 levels fused (range, 10–18 levels) were included. The mean preoperative coronal Cobb angle was 113° (range, 83°–144°), and a mean correction of 62° (54%) was achieved. There was a mean T1eS1 increase of 8.4 cm (range, 2.4–14 cm). Nine patients had 2-stage procedures separated by a mean of 7 days. Thirteen patients had a single procedure. Of 22 patients, 9 (41%) had intraoperative neuromonitoring changes. All neuromonitoring changes were reversed after releasing distraction on the temporary rod, except in 1 case. No patient had a clinical neurologic deficit. Conclusions Use of temporary distraction rods for severe scoliosis produces curve correction while providing a mean increase in T1eS1 height of 8 cm. Most steps in this surgery are reversible. Neuromonitoring changes are common, but they are reversible with release of some distraction. Neuromonitoring changes did not affect the final magnitude of correction, and there were no clinical neurologic deficits. We recommend that this procedure be performed only with good neuromonitoring. © Scoliosis Research Society 2014 |
| abstract_unstemmed |
Study Design Retrospective review of consecutive cases. Objective To examine the neurologic implications of applying intraoperative distraction to large curves. Summary Of Background Data Temporary rods provide internal distraction during correction of severe scoliosis and may be an alternative to prolonged halo traction or vertebral column resection. Methods A single surgeon’s consecutive experience with posterior-only spinal fusion with temporary distraction rods was reviewed retrospectively. Inclusion criteria were long posterior-only spinal fusion (10 or more levels) for severe scoliosis (major Cobb angle 80° or greater), treated with temporary internal distraction. Records were reviewed for age, gender, diagnosis, intraoperative course, and complications. Radiographs were reviewed for Cobb angles, T1eS1 length, and space available for each lung. Methods Twenty-two patients with a mean age of 14 years and a mean of 15 levels fused (range, 10–18 levels) were included. The mean preoperative coronal Cobb angle was 113° (range, 83°–144°), and a mean correction of 62° (54%) was achieved. There was a mean T1eS1 increase of 8.4 cm (range, 2.4–14 cm). Nine patients had 2-stage procedures separated by a mean of 7 days. Thirteen patients had a single procedure. Of 22 patients, 9 (41%) had intraoperative neuromonitoring changes. All neuromonitoring changes were reversed after releasing distraction on the temporary rod, except in 1 case. No patient had a clinical neurologic deficit. Conclusions Use of temporary distraction rods for severe scoliosis produces curve correction while providing a mean increase in T1eS1 height of 8 cm. Most steps in this surgery are reversible. Neuromonitoring changes are common, but they are reversible with release of some distraction. Neuromonitoring changes did not affect the final magnitude of correction, and there were no clinical neurologic deficits. We recommend that this procedure be performed only with good neuromonitoring. © Scoliosis Research Society 2014 |
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