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Experience in Perioperative Management of Patients Undergoing Posterior Spine Fusion for Neuromuscular Scoliosis

机译:后路脊柱融合神经肌肉性脊柱侧弯患者围手术期管理的经验

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摘要

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.
机译:这项研究的目的是使用Unit Rod技术确定脊柱融合治疗神经肌肉(NM)脊柱侧弯的结果,重点是与术前一般健康相关的并发症。在1997年至2007年间,回顾性分析了连续96例使用Unit Rod器械进行手术的神经肌肉性脊柱侧凸患者。纳入标准是诊断因脑瘫(CP)和肌营养不良(DMD)引起的NM脊柱侧弯。收集患者术前的总体健康状况,体重和营养状况。评价了不同的射线照相和临床参数。有66名CP患者(59名非行走者)和30名DMD患者(24名非行走者)。手术的平均年龄分别为16.5岁和13.9岁。所有射线照相测量值均显着改善。伤口感染率为16.7%(CP手术率为11%; DMD手术率为10%; 3个硬件去除病例)。没有观察到由于杆刺激引起的骨盆骨折。即使该手术与高并发症发生率相关,单位棒技术仍可提供良好的放射学和临床效果。这是一种快速,简单且可靠的技术。围手术期管理策略应减少术后并发症并增加结局。术前必须进行标准化的术前患者评估和准备,包括呼吸能力以及营养,消化和肌肉骨骼状态。

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