The long-term results of kyphectomy and spinal stabilization in children with myelomeningocele.
Ten myelomeningocele patients with a severe lumbar kyphosis were treated by resection of their kyphus, internal fixation, and spinal fusion. A mean kyphosis of 131 degrees was reduced to 44 degrees following the surgery. This was a very major procedure, associated with many complications. One patient died during the surgery and the remaining nine patients were followed for a mean of 7 years 4 months to skeletal maturity. The most successful methods of internal fixation were either by two Harrington distraction rods combined with compression across the osteotomy site (Group 3) or by a posteriorly applied AO plate (Group 2). A long posterior fusion extending from the mid-thoracic region to the sacrum was necessary to provide long-term stability and prevent the development of a thoracic lordosis. At skeletal maturity, all seven patients in Groups 2 and 3 had a flat back without pressure sores and all were able to sit upright without using their arms for support.
McMaster
M J
MJ
Edinburgh Scoliosis Unit, Scotland.
D001858:Bone Nails; D001860:Bone Plates; D002648:Child; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000209:etiology / Q000601:surgery*; D008297:Male; D008591:Meningomyelocele / Q000150:complications / Q000601:surgery*; D010027:Osteotomy / Q000379:methods; D013123:Spinal Fusion