Single-rod technique for the treatment of scoliosis - 5 years experience

Scliosis is a complex 3-dimensional and segmental deformity of the spine. Surgical treatment is indicated mainly for a growing child with increasing curve or in an already present severe deformity. Multi- segmental 3 dimensional correction gave better correction and fixation than the older systems. But it increased significantly the cost and difficulty of the procedure. To assess the results of using multisegmental fixation with a single rod for the treatment of scoliotic deformities. Subjects: There were 120 patients treated in this study by single rod technique for scoliosis of different aetiologies. There were 120 patients [Age: 5 to 18 years] treated by the single rod technique. The angle of the preoperative curve ranged from 45° to 110° with a mean of 61.4°. The curve flexibility ranged from 21% to 78% with a mean of 47.8%. The postoperative correction ranged from 47.4% to 85.7% with a mean correction of 64.7%, which was maintained until the final follow up [10-60 months, average = 42.6] without implant failure or pseudarthrosis. The use of a single rod for multisegmentalfixation for scolio tic deformities reduced the operative time, blood loss and cost. The implant was less bulky with increased surface area available for grafting which gives better fusion mass. The correction obtained was comparable with double rod technique

Spinal cord decompression and stabilization for secondries of the thoracic and lumbar spine

A retrospective assessment of the decompression-stabilization procedures for malignant spinal lesions was done. Twenty-six patients underwent decompression-stabilization procedures for metastatic spinal lesions. The patients were classified according to their malignant lesion involvement of the three columns of the spine. One column was involved in only one case, two columns were involved in eleven cases and three columns were involved in fourteen cases. A posterior approach alone was done in eight patients, while combined anterior- posterior approach was done in eighteen cases. A variety of posterior stabilization procedures was used. The results obtained from direct anterior approaches using vertebrectomy and anterior reconstruction of the anterior and middle columns produced the best results in terms of neurological improvement. Almost all of the patients had two or three columns involvement, but the results did not support the three columns theory, where the significant results regarding the pre- or postoperative radiographic measurements [mechanical instability] and pre- or postoperative neurologic findings [neurologic instability] could not be correlated with the number of the involved columns