Advertisement

Management of Vertebral Problems and Deformities

  • M. Memet Özek
  • Bülent Erol
  • Junichi Tamai

Abstract

Children with myelomeningocele have a high incidence of scoliosis, kyphosis and lordosis [1]. These spinal deformities are usually progressive and may cause severe disability, interfere with rehabilitation, and negate previous treatments aimed at maintaining ambulation. Spinal deformities may be congenital or acquired, specific to myelomeningocele or similar to deformities seen in other conditions. Although the majority of these deformities are paralytic and occur in childhood, as many as 15% may be congenital

Keywords

Pedicle Screw Spinal Fusion Spinal Deformity Pressure Sore Posterior Fusion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Herring JA (2002) Tachdjian’ s pediatric orthopaedics. WB Saunders, Philadelphia, pp 1249–1302Google Scholar
  2. 2.
    Samuelsson L, Eklof O (1988) Scoliosis in myelomeningocele. Acta Orthop Scand 59:122–127PubMedGoogle Scholar
  3. 3.
    Lindseth RE (2001) Myelomeningocele. In: Morrissy RT, Weinstein SL (eds) Lovell and Winter’ s pediatric orthopaedics. Lippincott Williams & Wilkins, Philadelphia, pp 601–632Google Scholar
  4. 4.
    Trivedi J, Thomson JD, Slakey JB et al (2002) Clinical and radiographic predictors of scoliosis in patients with myelomeningocele. J Bone Joint Surg 84A:1389–1394Google Scholar
  5. 5.
    Mackel JL, Lindseth RE (1975) Scoliosis in myelodysplasia. J Bone Joint Surg 57A:1031Google Scholar
  6. 6.
    Muller EB, Nordwall A, Oden A (1994) Progression of scoliosis in children with myelomeningocele. Spine 19:147–150PubMedGoogle Scholar
  7. 7.
    McLaughlin TP, Banta JV, Gahm NH et al (1986) Intraspinal rhizotomy and distal cordectomy in patients with a myelomeningocele. Pediatr Neurosurg 68:88–94Google Scholar
  8. 8.
    Breningstall GN, Marker SM, Tubman DE et al (1992) Hydrosyringomyelia and diastematomyelia detected by MRI in myelomeningocele. Pediatr Neurol 8:267–271PubMedCrossRefGoogle Scholar
  9. 9.
    Carstens C, Paul K, Niethard FU et al (1991) Effect of scoliosis surgery on pulmonary function in patients with myelomeningocele. J Pediatr Orthop 11:459–464PubMedGoogle Scholar
  10. 10.
    Banta JV, Park SM (1983) Improvement in pulmonary function in patients having combined anterior and posterior spine fusion for myelomeningocele scoliosis. Spine 8:765–770PubMedCrossRefGoogle Scholar
  11. 11.
    Muller EB, Nordwall A (1994) Brace treatment of scoliosis in children with myelomeningocele. Spine 19:151–155PubMedGoogle Scholar
  12. 12.
    Bunch WH (1975) The Milwaukee brace in paralytic scoliosis. Clin Orthop 110:63–68PubMedCrossRefGoogle Scholar
  13. 13.
    Boemers TM, Soorani-Lunsing IJ, de Jong TP et al (1996) Urological problems after surgical treatment of scoliosis in children with myelomeningocele. J Urol 155:1066–1069PubMedCrossRefGoogle Scholar
  14. 14.
    Mazur J, Menelaus MB, Dickens DR et al (1986) Efficacy of surgical management for scoliosis in myelomeningocele: correction of deformity and alteration of functional status. J Pediatr Orthop 6:568–575PubMedGoogle Scholar
  15. 15.
    Allen Jr BL, Ferguson RL (1984) The Galveston technique of pelvic fixation with L-rod instrumentation of the spine. Spine 9:388–394PubMedCrossRefGoogle Scholar
  16. 16.
    Neustadt JB, Shufflebarger HL, Cammisa FP (1992) Spinal fusions to the pelvis augmented by Cotrel-Dubousset instrumentation for neuromuscular scoliosis. J Pediatr Orthop 12:465–469PubMedGoogle Scholar
  17. 17.
    Perra JH (1994) Techniques of instrumentation in long fusions to the sacrum. Orthop Clin North Am 25:287–299PubMedGoogle Scholar
  18. 18.
    Widmann RF, Hresko T, Hall JE (1999) Lumbosacral fusion in children and adolescents using the modified sacral bar technique. Clin Orthop 364:85–91PubMedCrossRefGoogle Scholar
  19. 19.
    Lindseth RE (1978) Posterior iliac osteotomy for fixed pelvic obliquity. J Bone Joint Surg 60A:17–22Google Scholar
  20. 20.
    Muller EB, Nordwall A, von Wendt L (1992) Influence of surgical treatment of scoliosis in children with spina bifida on ambulation and motoric skills. Acta Paediatr 81:173–176PubMedCrossRefGoogle Scholar
  21. 21.
    Todore I, Dickens D (1998) The spine. In: Broughton N, Menelaus M (eds) Menelaus’ orthopaedic management of spina bifida cystica. WB Saunders, Philadelphia, pp 145–167Google Scholar
  22. 22.
    Banta JV (1990) Combined anterior and posterior fusion for spinal deformity in myelomeningocele. Spine 15:946–952PubMedCrossRefGoogle Scholar
  23. 23.
    Osebold WR, Mayfield JK, Winter RB et al (1982) Surgical treatment of paralytic scoliosis associated with myelomeningocele. J Bone Joint Surg 64A:841–856Google Scholar
  24. 24.
    Stark A, Saraste H (1993) Anterior fusion insufficient for scoliosis in myelomeningocele, 8 children 2-6 years after the Zielke operation. Acta Orthop Scand 64:22–24PubMedCrossRefGoogle Scholar
  25. 25.
    Ward WT, Wenger DR, Roach JW (1989) Surgical correction of myelomeningocele scoliosis: a critical appraisal of various spinal instrumentation systems. J Pediatr Orthop 9:262–268PubMedGoogle Scholar
  26. 26.
    Warner WC Jr, Fackler CD (1993) Comparison of two instrumentation techniques in treatment of lumbar kyphosis in myelodysplasia. J Pediatr Orthop 13:704–708PubMedGoogle Scholar
  27. 27.
    McMaster MJ (1988) The long-term results of kyphectomy and spinal stabilization in children with myelomeningocele. Spine 13:417–424PubMedCrossRefGoogle Scholar
  28. 28.
    Odent T, Vincent A, Ouellet J et al (2004) Kyphectomy in myelomeningocele with a modified Dunn-McCarthy technique followed by an anterior inlayed strut graft. Eur Spine 13:206–212CrossRefGoogle Scholar
  29. 29.
    Allen BL Jr (1979) The operative treatment of myelomeningocele spinal deformity. Orthop Clin North Am 10:845–862PubMedGoogle Scholar
  30. 30.
    Boachie-Adjei O, Lonstein JE, Winter RB et al (1989) Management of neuromuscular spinal deformities with Luque segmental instrumentation. J Bone Joint Surg 71A:548–562Google Scholar
  31. 31.
    Broom MJ, Banta JV, Renshaw TS (1989) Spinal fusion augmented by Luque-rod segmental instrumentation for neuromuscular scoliosis. J Bone Joint Surg 71A:32–44Google Scholar
  32. 32.
    Farcy JP, Rawlins BA, Glassman SD (1992) Technique and results of fixation to the sacrum with iliosacral screws. Spine 17(Suppl):S190–195CrossRefGoogle Scholar
  33. 33.
    Baker RH, Sharrard WJ (1973) Correction of lordoscoliosis in spina bifida by multiple spinal osteotomy and fusion Dwyer fixation: a preliminary report. Dev Med Child Neurol Suppl 29:12–23Google Scholar
  34. 34.
    Steel HH, Adams DJ (1972) Hyperlordosis caused by the lumboperitoneal shunt procedure for hydrocephalus. J Bone Joint Surg 54A:1537–1542Google Scholar
  35. 35.
    Hoppenfeld S (1967). Congenital kyphosis in myelo — meningocele. J Bone Joint Surg 49B:276–280Google Scholar
  36. 36.
    Shurtleff DB, Goiney R, Gordon LH et al (1976). Myelodysplasia: The natural history of kyphosis and scoliosis: A preliminary report. Dev Med Child Neurol Suppl 37:126–133Google Scholar
  37. 37.
    Carstens C, Koch H, Brocai DR et al (1996). Development of pathological lumbar kyphosis in myelo — menin gocele. J Bone Joint Surg 78B:945–950CrossRefGoogle Scholar
  38. 38.
    Roye BD (2005) Neuromuscular disorders. Myelo — menin gocele. In: Dormans JP (ed) Pediatric orthopaedics. Core knowledge in orthopaedics. Elsevier Mosby, Philadelphia, pp 483–504Google Scholar
  39. 39.
    Fromm B, Carstens C, Niethard FU et al (1992) Aortography in children with myelomeningocele and lumbar kyphosis. J Bone Joint Surg 74A:691–694Google Scholar
  40. 40.
    Lintner SA, Lindseth RE (1994) Kyphotic deformity in patients who have a myelomeningocele. Operative treatment and long-term follow-up. J Bone Joint Surg 76A:1301–1307Google Scholar
  41. 41.
    Sharrard WJ, Drennan JC (1972) Osteotomy-excision of the spine for lumbar kyphosis in older children with myelomeningocele. J Bone Joint Surg 54B:50–60Google Scholar
  42. 42.
    Lindseth RE, Stelzer L (1979) Vertebral excision for kyphosis in children with myelomeningocele. J Bone Joint Surg 61A:699–704Google Scholar
  43. 43.
    McCall RE (1998) Modified Luque instrumentation after myelomeningocele kyphectomy. Spine 23:1406–1411PubMedCrossRefGoogle Scholar
  44. 44.
    Nolden MT, Sarwark JF, Vora A et al (2002) A kyphectomy technique with reduced perioperative morbidity for myelomeningocele kyphosis. Spine 27:1807–1813PubMedCrossRefGoogle Scholar
  45. 45.
    Niall DM, Dowling FE, Fogarty EE et al (2004) Kyphectomy in children with myelomeningocele. A long-term outcome study. J Pediatr Orthop 24:37–44PubMedGoogle Scholar
  46. 46.
    Heydermann JS, Gillespie R (1987) Management of myelomeningocelekyphosis in the older child by kyphectomy and segmental spinal instrumentation. Spine 12:37–41CrossRefGoogle Scholar
  47. 47.
    Hall JE, Poitra B (1977) The management of kyphosis in patients with myelomeningocele. Clin Orthop 128:33–40PubMedGoogle Scholar
  48. 48.
    Eyring EJ, Wanken JJ, Sayers MP (1972) Spinal osteotomy for kyphosis in myelomeningocele. Clin Orthop 88:24–30PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2008

Authors and Affiliations

  • M. Memet Özek
    • 1
  • Bülent Erol
    • 2
  • Junichi Tamai
    • 3
  1. 1.Division of Pediatric Neurosurgery Marmara University Medical Center and Department of NeurosurgeryAcibadem University School of MedicineIstanbulTurkey
  2. 2.Department of Orthopaedics and TraumatologyMarmara University Medical CenterIstanbulTurkey
  3. 3.Department of Orthopaedic SurgeryCincinnati Children’s Hospital Medical CenterCincinnatiUSA

Personalised recommendations