STUDY DESIGN: Retrospective. OBJECTIVE: To report on the treatment of patients with cerebral palsy and neuropathic scoliosis with third-generation instrumented spinal fusion by Cotrel-Dubousset instrumentation. SUMMARY OF BACKGROUND DATA: Second-generation instrumented spinal fusion is considered the standard for progressive neuropathic scoliosis in cerebral palsy, despite high complication rates. Evidence is needed to evaluate the increasing use of third-generation instrumented spinal fusion in similar patients. METHODS: Patients with cerebral palsy and spinal deformity treated consecutively by 1 surgeon with Cotrel-Dubousset instrumentation and minimum 2-year follow-up were reviewed. An outcome questionnaire was administered at final follow-up. RESULTS: A total of 60 patients were included. Mean age was 15 years at surgery. Mean follow-up was 79 months. There were 26 anteroposterior and 34 posterior-only procedures. Correction of coronal deformity and pelvic obliquity averaged 60\% and 40\%, respectively. Major complications affected 13.5\% of patients, and included implant loosening, deep infection, and pseudarthrosis. Minor complications affected 10\% of patients. Outcome questionnaires showed marked improvements in the areas of satisfaction, function, and quality of life after surgery. CONCLUSIONS: Segmental, third-generation instrumented spinal fusion provides lasting correction of spinal deformity and improved quality of life in patients with cerebral palsy and neuropathic scoliosis, with a lower pseudarthrosis rate compared to reports on second-generation instrumented spinal fusion.
%0 Journal Article
%1 Teli2006
%A Teli, Marco G A
%A Cinnella, Pasquale
%A Vincitorio, Fiammetta
%A Lovi, Alessio
%A Grava, Giuseppe
%A Brayda-Bruno, Marco
%D 2006
%J Spine
%K Adolescent; Adult; Cerebral Palsy; Child; Cohort Studies; Female; Follow-Up Humans; Incidence; Infection; Internal Fixators; Male; Patient Satisfaction; Pseudarthrosis; Quadriplegia; Quality of Life; Questionnaires; Retrospective Scoliosis; Spinal Fusion; Treatment Outcome
%N 14
%P E441--E447
%R 10.1097/01.brs.0000221986.07992.fb
%T Spinal fusion with Cotrel-Dubousset instrumentation for neuropathic scoliosis in patients with cerebral palsy.
%U http://dx.doi.org/10.1097/01.brs.0000221986.07992.fb
%V 31
%X STUDY DESIGN: Retrospective. OBJECTIVE: To report on the treatment of patients with cerebral palsy and neuropathic scoliosis with third-generation instrumented spinal fusion by Cotrel-Dubousset instrumentation. SUMMARY OF BACKGROUND DATA: Second-generation instrumented spinal fusion is considered the standard for progressive neuropathic scoliosis in cerebral palsy, despite high complication rates. Evidence is needed to evaluate the increasing use of third-generation instrumented spinal fusion in similar patients. METHODS: Patients with cerebral palsy and spinal deformity treated consecutively by 1 surgeon with Cotrel-Dubousset instrumentation and minimum 2-year follow-up were reviewed. An outcome questionnaire was administered at final follow-up. RESULTS: A total of 60 patients were included. Mean age was 15 years at surgery. Mean follow-up was 79 months. There were 26 anteroposterior and 34 posterior-only procedures. Correction of coronal deformity and pelvic obliquity averaged 60\% and 40\%, respectively. Major complications affected 13.5\% of patients, and included implant loosening, deep infection, and pseudarthrosis. Minor complications affected 10\% of patients. Outcome questionnaires showed marked improvements in the areas of satisfaction, function, and quality of life after surgery. CONCLUSIONS: Segmental, third-generation instrumented spinal fusion provides lasting correction of spinal deformity and improved quality of life in patients with cerebral palsy and neuropathic scoliosis, with a lower pseudarthrosis rate compared to reports on second-generation instrumented spinal fusion.
@article{Teli2006,
abstract = {STUDY DESIGN: Retrospective. OBJECTIVE: To report on the treatment of patients with cerebral palsy and neuropathic scoliosis with third-generation instrumented spinal fusion by Cotrel-Dubousset instrumentation. SUMMARY OF BACKGROUND DATA: Second-generation instrumented spinal fusion is considered the standard for progressive neuropathic scoliosis in cerebral palsy, despite high complication rates. Evidence is needed to evaluate the increasing use of third-generation instrumented spinal fusion in similar patients. METHODS: Patients with cerebral palsy and spinal deformity treated consecutively by 1 surgeon with Cotrel-Dubousset instrumentation and minimum 2-year follow-up were reviewed. An outcome questionnaire was administered at final follow-up. RESULTS: A total of 60 patients were included. Mean age was 15 years at surgery. Mean follow-up was 79 months. There were 26 anteroposterior and 34 posterior-only procedures. Correction of coronal deformity and pelvic obliquity averaged 60\% and 40\%, respectively. Major complications affected 13.5\% of patients, and included implant loosening, deep infection, and pseudarthrosis. Minor complications affected 10\% of patients. Outcome questionnaires showed marked improvements in the areas of satisfaction, function, and quality of life after surgery. CONCLUSIONS: Segmental, third-generation instrumented spinal fusion provides lasting correction of spinal deformity and improved quality of life in patients with cerebral palsy and neuropathic scoliosis, with a lower pseudarthrosis rate compared to reports on second-generation instrumented spinal fusion.},
added-at = {2014-07-19T21:42:45.000+0200},
author = {Teli, Marco G A and Cinnella, Pasquale and Vincitorio, Fiammetta and Lovi, Alessio and Grava, Giuseppe and Brayda-Bruno, Marco},
biburl = {https://www.bibsonomy.org/bibtex/2da9ebf8379600aa9199be086561a8f5e/ar0berts},
doi = {10.1097/01.brs.0000221986.07992.fb},
groups = {public},
interhash = {6e2d4a540b089bbe208f80b1fc605d0d},
intrahash = {da9ebf8379600aa9199be086561a8f5e},
journal = {Spine},
keywords = {Adolescent; Adult; Cerebral Palsy; Child; Cohort Studies; Female; Follow-Up Humans; Incidence; Infection; Internal Fixators; Male; Patient Satisfaction; Pseudarthrosis; Quadriplegia; Quality of Life; Questionnaires; Retrospective Scoliosis; Spinal Fusion; Treatment Outcome},
month = Jun,
number = 14,
pages = {E441--E447},
pii = {00007632-200606150-00030},
pmid = {16778673},
timestamp = {2014-07-19T21:48:05.000+0200},
title = {Spinal fusion with Cotrel-Dubousset instrumentation for neuropathic scoliosis in patients with cerebral palsy.},
url = {http://dx.doi.org/10.1097/01.brs.0000221986.07992.fb},
username = {ar0berts},
volume = 31,
year = 2006
}