5-Year Follow-Up Data for Fusionless Scoliosis Treatment

A minimally invasive fusionless technique can be a good alternative to arthrodesis for neuromuscular scoliosis, according to a new study with 5-year follow-up data.

The study, “Minimally Invasive Surgery for Neuromuscular Scoliosis: Results and Complications at a Minimal Follow-up of 5 Years” is published in the December 2021 issue of the journal Spine.

The researchers collected patient outcome data for a minimally invasive fusionless approach to growing rods for neuromuscular scoliosis that uses.

“Conservative treatment is not effective in progressive neuromuscular scoliosis. Early surgery using growing rods is increasingly advocated to control the deformity while preserving spinal and thoracic growth before arthrodesis. These techniques still provide a high rate of complications,” they wrote.

This alternative approach involves using “a bilateral double rod sliding instrumentation anchored proximally by four hook claws and distally to the pelvis by iliosacral screws via a minimally invasive approach.

Eighty-three patients were included in the final analysis. The researchers collected clinical and radiological data during a follow-up of 5 years. Overall, the mean Cobb angle was stable to 35.0° which corresponded to 61% correction of the initial deformation. Mean pelvic obliquity was 29.6° (0.3° –80.0°) preoperatively and 7.2 (0.2°–23.5°) at final follow-up.

The researchers reported that correction of the hyperkyphosis remained stable, and skeletal maturity was reached in 42 of 83 patients. None of the patients went on to have spinal fusion. The global complication rate was 31. 3%.

“The outcomes of this minimally invasive fusionless technique at 5 years follow-up showed a stable correction of spinal deformities and pelvic obliquity over time, with a reduced rate of complication. The arthrodesis was not required for all patients at skeletal maturity. This technique could be a good alternative to arthrodesis for neuromuscular scoliosis,” the researchers wrote.

Study authors include Mathilde Gaume, M.D., of Necker Hospital, Université de Paris, Assistance Publique Hôpitaux de Paris and Arts et Métiers ParisTech, LBM/lnstitut de Biomécanique Humaine Georges Charpak, Paris, France, Claudio Vergari, M.D., of Arts et Métiers ParisTech, LBM/lnstitut de Biomécanique Humaine Georges Charpak, Paris, France, Neijb Khouri, M.D.., of Necker Hospital, Université de Paris, Assistance Publique Hôpitaux de Paris , Wafa Skalli, M.D., of Arts et Métiers ParisTech, LBM/lnstitut de Biomécanique Humaine Georges Charpak, Paris, France, Christophe Glorion, M.D., of Necker Hospital, Université de Paris, Assistance Publique Hôpitaux de Paris and Lotfi Miladi, M.D. of Necker Hospital, Université de Paris, Assistance Publique Hôpitaux de Paris.