- Discussion:
- in adults, a two-stage anterior and posterior procedure is performed;
- w/ this technique, rate of pseudarthrosis is < 5 %;
- CD instrumentation:
- another advantage of this instrumentation is improved fixation to sacrum, w/ pedicular screws used instead of Harrington hooks or
Luque rods;
- Myelomenigocele:
- arthrodesis to pelvis is often needed to correct severe pelvic obliquity and dysraphism;
- in pts w/ high-level myelomeningocele, it is important to fuse to sacrum if the curve is major and cannot be corrected below 15 deg;
- in child w/ low lumbar myelomeningocele who is able to walk, a fusion to sacrum will impair walking ability & confine child to wheelchair;
- sacrum is not be fused in walking child unless absolutely necessary
Fusion to the sacrum for nonparalytic scoliosis in the adult.
The Galveston experience with L-rod instrumentation for adolescent idiopathic scoliosis.