Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Posterior Spinal Fusion Surgery for Neuromuscular Disease Patients With Severe Scoliosis Whose Cobb Angle was Over 100 Degrees

Masayuki Miyagi
* ORCID logo ,
Wataru Saito
,
Yusuke Mimura
,
Toshiyuki Nakazawa
,
Takayuki Imura
,
Eiki Shirasawa
,
Kentaro Uchida
ORCID logo ,
Shinsuke Ikeda
,
Akiyoshi Kuroda
,
Sho Inoue
,
Yuji Yokozeki
,
Yoshihide Tanaka
,
Tsutomu Akazawa
ORCID logo ,
Masashi Takaso
,
Gen Inoue
ORCID logo
Version 1 : Received: 5 May 2023 / Approved: 9 May 2023 / Online: 9 May 2023 (12:35:41 CEST)

A peer-reviewed article of this Preprint also exists.

Miyagi, M.; Saito, W.; Mimura, Y.; Nakazawa, T.; Imura, T.; Shirasawa, E.; Uchida, K.; Ikeda, S.; Kuroda, A.; Inoue, S.; Yokozeki, Y.; Tanaka, Y.; Akazawa, T.; Takaso, M.; Inoue, G. Posterior Spinal Fusion Surgery for Neuromuscular Disease Patients with Severe Scoliosis Whose Cobb Angle Was over 100 Degrees. Medicina 2023, 59, 1090. Miyagi, M.; Saito, W.; Mimura, Y.; Nakazawa, T.; Imura, T.; Shirasawa, E.; Uchida, K.; Ikeda, S.; Kuroda, A.; Inoue, S.; Yokozeki, Y.; Tanaka, Y.; Akazawa, T.; Takaso, M.; Inoue, G. Posterior Spinal Fusion Surgery for Neuromuscular Disease Patients with Severe Scoliosis Whose Cobb Angle Was over 100 Degrees. Medicina 2023, 59, 1090.

Abstract

Patients with neuromuscular diseases usually have progressive neuromuscular scoliosis (NMS), requiring invasive surgery. Some patients present with severe scoliosis at the time of consultation and are difficult to treat. Posterior spinal fusion (PSF) surgery combined with anterior release and pre or intraoperative traction would be effective for severe spinal deformity, but invasive. This study aimed to evaluate the outcomes of PSF only surgery for patients with severe NMS with Cobb angle >100 °. Thirty NMS patients (13 boys and 17 girls; mean age 13.8 years) who underwent PSF only surgery for scoliosis with Cobb angle >100 ° were included. We reviewed the lower instrumented vertebra (LIV), duration of surgery, blood loss, perioperative complications, preoperative clinical findings, and radiographic findings including Cobb angle and pelvic obliquity (PO) in the sitting position pre and postoperatively. The correction rate and correction loss of the Cobb angle and PO were also calculated. The mean duration of surgery was 338 min, intraoperative blood loss was 1,440 mL, preoperative %VC was 34.1%, FEV1.0 (%) was 91.5%, and EF was 66.1%. There were eight cases of perioperative complications. The Cobb angle and PO correction rates were 48.5% and 42.0%, respectively. We divided the patients into two groups: the L5 group, in which the LIV was L5, and the pelvis group, in which the LIV was the pelvis. The duration of surgery and PO correction rate in the pelvis group was significantly higher than that of the L5 group. Patients with severe NMS demonstrated severe preoperative restrictive ventilatory impairments. PSF only surgery for severe NMS showed satisfactory outcomes, although highly invasive. Instrumentation and fusion to the pelvis for severe scoliosis in patients with NMS showed good PO correction and low correction loss of Cobb angle and PO, but a longer duration of surgery.

Keywords

neuromuscular diseases; scoliosis; posterior spinal fusion surgery; Cobb angle

Subject

Medicine and Pharmacology, Orthopedics and Sports Medicine

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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