Temporary internal distraction rod is one of the surgical options in severe scoliosis to avoid preoperative halo traction or vertebral column resection. This technique can be applied in a single session or staged. The aim of our study was to report the outcomes of less invasive temporary internal distraction (LI-TID) in the surgical treatment of adolescents with severe idiopathic scoliosis (SS).
A single-center, retrospective study with a minimum 2-year follow up. 22 adolescents (19 girls, mean [SD] age 14.8 [2.0] years) with SS (major curve ≥ 90°), who were treated using the LI-TID followed by staged pedicle screw instrumentation with minimum two-year follow-up. Demographic data, radiographic outcomes, pulmonary function tests (PFTs), perioperative data, SRS 22r outcome questionnaire, complications, and neuromonitoring (NM) data were collected.
The major curve averaged preoperatively 120° (90-160°) and 59° (29-69°) at final follow-up. Similarly, thoracic kyphosis (T5-T12) improved from averaged 80° to 33° (22°- 69°), and spinal height (T1-S1) increased from 332 mm (198-432 mm) to 405 mm (258-495 mm). Five (22%) children had an intraoperative neuromonitoring change without postoperative neurologic deficits and two children developed superior mesenteric artery syndrome treated conservatively. Mean per cent predicted forced vital capacity (FVC) improved from 44.5% (11.3%) to 66.5 (10.8) at final follow-up(p<0.05). The SRS-22R total score improved significantly from 2.9 (0.61) to 4.1 (0.44) (p<0.05).
Staged LI-TID followed by pedicle screw instrumentation is safe and effective in adolescents with SS improving spinal deformity, pulmonary function, and health-related quality.
Copyright © 2020. Published by Elsevier Inc.