Autogenous tibial strut grafts used in severe kyphoscoliosis:surgical policies and preliminary results
- Author:
- No author available
- Journal Title:
- CHINESE MEDICAL JOURNAL
- Issue:
- 15
- DOI:
- No doi available
- Key Word:
- kyphoscoliosis;tibial strut;autogenous
Abstract： Background Surgery for severe kyphoscoliosis is frequently unsatisfying because of loss of correction, high rate of pseudarthrosis and neurological complications.Several authors reported that the anterior fusion with strut grafts might improve the surgical outcome.This article describes and assesses the surgical strategies and the application of autogenous tibial strut in the treatment of severe kyphoscoliosis.Results The mean preoperative and postoperative kyphosis was 82°and 52°respectively, and the mean scoliosis was 84°and 44°respectively.Complications included pseudarthrosis (2 cases, one with graft fracture and the other with hook displacement), posterior elements fractures (4), pleura penetrations (3, in the plastic surgery of the thoracic cage), dura tear (2), exudative pleuritis (2, in the anterior surgery), and tibia fracture of the harvesting site (1).The mean loss of correction in coronal and sagittal plane was 6° and 7° respectively.Except for 1 case, the patients with incomplete paraplegia showed improvements to varying extents.Conclusion Autogenous tibial strut can provide excellent support to the kyphoscoliotic spine: it reduces pseudarthrodic rate, loss of correction and complications of graft harvest, it also prevents the occurrence of neurological impairment.
- [1]D S, Bradford,S, Ganjavian,D, Antonious,etc.Anterior strut-grafting for the treatment of kyphosis. Review of experience with forty-eight patients.[J].1982,64.
- [2]R D, Zeller,I, Ghanem,J, Dubousset.The congenital dislocated spine.[J].1996,21.
- [3]Barbieri CH,Mazer MR,Mazzer N.Use of a delayed cortical bone graft to treat diaphyseal defects in the forearm.[J].1999,23(5).
- [4]L C, Hsu,A C, Yau,J P, O'Brien,etc.Valgus deformity of the ankle resulting from fibular resection for a graft in subtalar fusion in children.[J].1972,54.
- [5]H W, Kim,S L, Weinstein.Spine update. The management of scoliosis in neurofibromatosis.[J].1997,22.
- [6]Garfin SR,Lee G,Kim CW,etc.Use of vascularized fibular grafts as a salvage procedure for previously failed spinal arthrodesis.[J].2001,26(19).
- [7]R D, Zeller,I, Ghanem,L, Miladi,etc.Posterior spinal fusion in neuromuscular scoliosis using a tibial strut graft. Results of a long-term follow-up.[J].1994,19.
- [8]Bridwell KH,Molinari RW,Klepps SJ,etc.Minimum 5-year follow-up of anterior column structural allografts in the thoracic and lumbar spine.[J].1999,24(10).
- [9]G, Bassett,C, Johnson,P, Stanley.Comparison of preoperative selective spinal angiography and somatosensory-evoked potential monitoring with temporary occlusion of segmental vessels during anterior spinal surgery.[J].1996,21.
- [10]Kim YJ,Hall JE,Emans JB,etc.Surgical treatment of congenital kyphosis.[J].2001,26(20).
- [11]Parisini P,Di Silvestre-M,Greggi T,etc.Surgical correction of dystrophic spinal curves in neurofibromatosis. A review of 56 patients.[J].1999,24(21).
- [12]M J, McMaster,H, Singh.Natural history of congenital kyphosis and kyphoscoliosis. A study of one hundred and twelve patients.[J].1999,81.
- [13]Bernstein RM,Yu WD,Watts HG.Autogenous tibial strut grafts used in anterior spinal fusion for severe kyphosis and kyphoscoliosis.[J].2003,28(7).
- [14]Dubousset J,Zeller RD.Progressive rotational dislocation in kyphoscoliotic deformities: presentation and treatment.[J].2000,25(9).
- [15]McMaster MJ,Singh H.The surgical management of congenital kyphosis and kyphoscoliosis.[J].2001,26(19).