Outcome and complications of intermittent distracting rod for correction of severe scoliosis in young children
- VernacularTitle:后路可延长型内固定矫正儿童脊柱侧凸的疗效及并发症
- Author:
Yong QIU
;
Zezhang ZHU
;
Bin WANG
- Publication Type:Journal Article
- Keywords:
Scoliosis;
Spinal fusion;
Internal fixators;
Postoperative complications
- From:
Chinese Journal of Orthopaedics
2001;0(03):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical outcome of intermittent distracting rod for the correction of juvenile scoliosis, and analyze its complications. Methods Between July 1997 through June 2002, 21 patients with scoliosis underwent posterior growing-rod instrumentation, with their age ranged from 6 to 11 years. Risser sign was 0 in all patients. Average curve magnitude was 78 degrees (62 to 94 degrees) before initial instrumentation. A pair of claw-type hooks were inserted at the upper and lower levels respectively, one rod was attached to the upper hooks and the other to the lower hooks. These two rods were allowed to overlap and were connected with a growth connector. Distraction was achieved by means of lengthening the two rods at the connector site. Repetition of lengthening was indicated by the curve deterioration larger than 15 degrees or the interval of 10 to 12 months after the previous operation. After each operation, a Milwaukee brace was worn for external support. Results The initial intraoperative correction averaged 40 degrees, but this decreased to 23 degrees of correction on average at every subsequent lengthening. The total distraction procedure of 4 times only achieved in 5 patients. The reasons for distraction ceasing were as follows: hook dislodgment in 3 patients, looseness of pedicle screw in 2, looseness of dominos connector in 2, wound infection in 1, spontaneous fusion in 2, and insufficient financial support in 6. Conclusion Curve response to correction tends to decline with consecutive distractions. A high rate of complications has been noted during the distraction procedure. The single distracting rod technique is not suitable for the correction of severe scoliosis in Chinese children.
