title: Experience in Perioperative Management of Patients Undergoing Posterior Spine Fusion for Neuromuscular Scoliosis.
abstract: The objective of this investigation was to determine the outcome of spine fusion for neuromuscular (NM) scoliosis, using Unit Rod technique, with emphasis on complications related to preoperative general health. Between 1997 and 2007, 96 consecutive patients with neuromuscular scoliosis operated on with Unit Rod instrumentation were retrospectively reviewed. The inclusion criteria were diagnosis of NM scoliosis due to cerebral palsy (CP) and muscular dystrophy (DMD). Patient's preoperative general health, weight, and nutrition were collected. Different radiographic and clinical parameters were evaluated. There were 66 CP patients (59 nonwalking) and 30 DMD patients (24 nonwalking). Mean age at surgery was 16.5 years and 13.9 years, respectively. All radiographic measurements improved significantly. Wound infection rate was 16.7% (11% of reoperation rate in CP; 10% in DMD; 3 hardware removal cases). No pelvic fracture due to rod irritation was observed. Unit Rod technique provides good radiographic and clinical outcomes even if this surgery is associated with a high complication rate. It is a quick, simple, and reliable technique. Perioperative management strategy should decrease postoperative complications and increases outcome. A standardized preoperative patient evaluation and preparation including respiratory capacity and nutritional, digestive, and musculoskeletal status are mandatory prior to surgery.
authors.affiliation: Pediatric Orthopedics, Timone, Aix-Marseille University, 264 rue Saint Pierre, 13005 Marseille, France; Aix-Marseille University, CNRS, ISM, Inst Movement Sci, Marseille, France.
authors.forename: Sébastien
authors.identifier: 0000-0003-2230-2811
authors.initials: S
authors.lastname: Pesenti
authors.affiliation: Aix-Marseille University, CNRS, ISM, Inst Movement Sci, Marseille, France; Spine Unit, Timone, Aix-Marseille University, 264 rue Saint Pierre, 13005 Marseille, France.
authors.forename: Benjamin
authors.identifier: 0000-0001-8896-5277
authors.initials: B
authors.lastname: Blondel
authors.affiliation: Pediatric Orthopedics, Timone, Aix-Marseille University, 264 rue Saint Pierre, 13005 Marseille, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Peltier
authors.affiliation: Pediatric Orthopedics, Timone, Aix-Marseille University, 264 rue Saint Pierre, 13005 Marseille, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Launay
authors.affiliation: Aix-Marseille University, CNRS, ISM, Inst Movement Sci, Marseille, France; Spine Unit, Timone, Aix-Marseille University, 264 rue Saint Pierre, 13005 Marseille, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Fuentes
authors.affiliation: Pediatric Orthopedics, Timone, Aix-Marseille University, 264 rue Saint Pierre, 13005 Marseille, France.
authors.forename: Gérard
authors.initials: G
authors.lastname: Bollini
authors.affiliation: Pediatric Orthopedics, Timone, Aix-Marseille University, 264 rue Saint Pierre, 13005 Marseille, France; Aix-Marseille University, CNRS, ISM, Inst Movement Sci, Marseille, France.
authors.forename: Elke
authors.initials: E
authors.lastname: Viehweger
authors.affiliation: Pediatric Orthopedics, Timone, Aix-Marseille University, 264 rue Saint Pierre, 13005 Marseille, France.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Jouve
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009468:Neuromuscular Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D019990:Perioperative Care / Q000379:methods*; D012189:Retrospective Studies; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion