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The Spina Bifida pp 305–317Cite as

Management of Vertebral Problems and Deformities

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Abstract

Children with myelomeningocele have a high incidence of scoliosis, kyphosis and lordosis [1]. These spinal deformities are usually progressive and may cause severe disability, interfere with rehabilitation, and negate previous treatments aimed at maintaining ambulation. Spinal deformities may be congenital or acquired, specific to myelomeningocele or similar to deformities seen in other conditions. Although the majority of these deformities are paralytic and occur in childhood, as many as 15% may be congenital

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References

  1. Herring JA (2002) Tachdjian’ s pediatric orthopaedics. WB Saunders, Philadelphia, pp 1249–1302

    Google Scholar 

  2. Samuelsson L, Eklof O (1988) Scoliosis in myelomeningocele. Acta Orthop Scand 59:122–127

    PubMed  CAS  Google Scholar 

  3. Lindseth RE (2001) Myelomeningocele. In: Morrissy RT, Weinstein SL (eds) Lovell and Winter’ s pediatric orthopaedics. Lippincott Williams & Wilkins, Philadelphia, pp 601–632

    Google Scholar 

  4. Trivedi J, Thomson JD, Slakey JB et al (2002) Clinical and radiographic predictors of scoliosis in patients with myelomeningocele. J Bone Joint Surg 84A:1389–1394

    Google Scholar 

  5. Mackel JL, Lindseth RE (1975) Scoliosis in myelodysplasia. J Bone Joint Surg 57A:1031

    Google Scholar 

  6. Muller EB, Nordwall A, Oden A (1994) Progression of scoliosis in children with myelomeningocele. Spine 19:147–150

    PubMed  CAS  Google Scholar 

  7. McLaughlin TP, Banta JV, Gahm NH et al (1986) Intraspinal rhizotomy and distal cordectomy in patients with a myelomeningocele. Pediatr Neurosurg 68:88–94

    CAS  Google Scholar 

  8. Breningstall GN, Marker SM, Tubman DE et al (1992) Hydrosyringomyelia and diastematomyelia detected by MRI in myelomeningocele. Pediatr Neurol 8:267–271

    Article  PubMed  CAS  Google Scholar 

  9. Carstens C, Paul K, Niethard FU et al (1991) Effect of scoliosis surgery on pulmonary function in patients with myelomeningocele. J Pediatr Orthop 11:459–464

    PubMed  CAS  Google Scholar 

  10. Banta JV, Park SM (1983) Improvement in pulmonary function in patients having combined anterior and posterior spine fusion for myelomeningocele scoliosis. Spine 8:765–770

    Article  PubMed  CAS  Google Scholar 

  11. Muller EB, Nordwall A (1994) Brace treatment of scoliosis in children with myelomeningocele. Spine 19:151–155

    PubMed  CAS  Google Scholar 

  12. Bunch WH (1975) The Milwaukee brace in paralytic scoliosis. Clin Orthop 110:63–68

    Article  PubMed  Google Scholar 

  13. Boemers TM, Soorani-Lunsing IJ, de Jong TP et al (1996) Urological problems after surgical treatment of scoliosis in children with myelomeningocele. J Urol 155:1066–1069

    Article  PubMed  CAS  Google Scholar 

  14. Mazur J, Menelaus MB, Dickens DR et al (1986) Efficacy of surgical management for scoliosis in myelomeningocele: correction of deformity and alteration of functional status. J Pediatr Orthop 6:568–575

    PubMed  CAS  Google Scholar 

  15. Allen Jr BL, Ferguson RL (1984) The Galveston technique of pelvic fixation with L-rod instrumentation of the spine. Spine 9:388–394

    Article  PubMed  Google Scholar 

  16. Neustadt JB, Shufflebarger HL, Cammisa FP (1992) Spinal fusions to the pelvis augmented by Cotrel-Dubousset instrumentation for neuromuscular scoliosis. J Pediatr Orthop 12:465–469

    PubMed  CAS  Google Scholar 

  17. Perra JH (1994) Techniques of instrumentation in long fusions to the sacrum. Orthop Clin North Am 25:287–299

    PubMed  CAS  Google Scholar 

  18. Widmann RF, Hresko T, Hall JE (1999) Lumbosacral fusion in children and adolescents using the modified sacral bar technique. Clin Orthop 364:85–91

    Article  PubMed  Google Scholar 

  19. Lindseth RE (1978) Posterior iliac osteotomy for fixed pelvic obliquity. J Bone Joint Surg 60A:17–22

    Google Scholar 

  20. Muller EB, Nordwall A, von Wendt L (1992) Influence of surgical treatment of scoliosis in children with spina bifida on ambulation and motoric skills. Acta Paediatr 81:173–176

    Article  PubMed  CAS  Google Scholar 

  21. Todore I, Dickens D (1998) The spine. In: Broughton N, Menelaus M (eds) Menelaus’ orthopaedic management of spina bifida cystica. WB Saunders, Philadelphia, pp 145–167

    Google Scholar 

  22. Banta JV (1990) Combined anterior and posterior fusion for spinal deformity in myelomeningocele. Spine 15:946–952

    Article  PubMed  CAS  Google Scholar 

  23. Osebold WR, Mayfield JK, Winter RB et al (1982) Surgical treatment of paralytic scoliosis associated with myelomeningocele. J Bone Joint Surg 64A:841–856

    Google Scholar 

  24. Stark A, Saraste H (1993) Anterior fusion insufficient for scoliosis in myelomeningocele, 8 children 2-6 years after the Zielke operation. Acta Orthop Scand 64:22–24

    Article  PubMed  CAS  Google Scholar 

  25. Ward WT, Wenger DR, Roach JW (1989) Surgical correction of myelomeningocele scoliosis: a critical appraisal of various spinal instrumentation systems. J Pediatr Orthop 9:262–268

    PubMed  CAS  Google Scholar 

  26. Warner WC Jr, Fackler CD (1993) Comparison of two instrumentation techniques in treatment of lumbar kyphosis in myelodysplasia. J Pediatr Orthop 13:704–708

    PubMed  Google Scholar 

  27. McMaster MJ (1988) The long-term results of kyphectomy and spinal stabilization in children with myelomeningocele. Spine 13:417–424

    Article  PubMed  CAS  Google Scholar 

  28. Odent T, Vincent A, Ouellet J et al (2004) Kyphectomy in myelomeningocele with a modified Dunn-McCarthy technique followed by an anterior inlayed strut graft. Eur Spine 13:206–212

    Article  Google Scholar 

  29. Allen BL Jr (1979) The operative treatment of myelomeningocele spinal deformity. Orthop Clin North Am 10:845–862

    PubMed  Google Scholar 

  30. Boachie-Adjei O, Lonstein JE, Winter RB et al (1989) Management of neuromuscular spinal deformities with Luque segmental instrumentation. J Bone Joint Surg 71A:548–562

    Google Scholar 

  31. Broom MJ, Banta JV, Renshaw TS (1989) Spinal fusion augmented by Luque-rod segmental instrumentation for neuromuscular scoliosis. J Bone Joint Surg 71A:32–44

    Google Scholar 

  32. Farcy JP, Rawlins BA, Glassman SD (1992) Technique and results of fixation to the sacrum with iliosacral screws. Spine 17(Suppl):S190–195

    Article  Google Scholar 

  33. Baker RH, Sharrard WJ (1973) Correction of lordoscoliosis in spina bifida by multiple spinal osteotomy and fusion Dwyer fixation: a preliminary report. Dev Med Child Neurol Suppl 29:12–23

    Google Scholar 

  34. Steel HH, Adams DJ (1972) Hyperlordosis caused by the lumboperitoneal shunt procedure for hydrocephalus. J Bone Joint Surg 54A:1537–1542

    Google Scholar 

  35. Hoppenfeld S (1967). Congenital kyphosis in myelo — meningocele. J Bone Joint Surg 49B:276–280

    Google Scholar 

  36. Shurtleff DB, Goiney R, Gordon LH et al (1976). Myelodysplasia: The natural history of kyphosis and scoliosis: A preliminary report. Dev Med Child Neurol Suppl 37:126–133

    Google Scholar 

  37. Carstens C, Koch H, Brocai DR et al (1996). Development of pathological lumbar kyphosis in myelo — menin gocele. J Bone Joint Surg 78B:945–950

    Article  Google Scholar 

  38. Roye BD (2005) Neuromuscular disorders. Myelo — menin gocele. In: Dormans JP (ed) Pediatric orthopaedics. Core knowledge in orthopaedics. Elsevier Mosby, Philadelphia, pp 483–504

    Google Scholar 

  39. Fromm B, Carstens C, Niethard FU et al (1992) Aortography in children with myelomeningocele and lumbar kyphosis. J Bone Joint Surg 74A:691–694

    Google Scholar 

  40. Lintner SA, Lindseth RE (1994) Kyphotic deformity in patients who have a myelomeningocele. Operative treatment and long-term follow-up. J Bone Joint Surg 76A:1301–1307

    Google Scholar 

  41. Sharrard WJ, Drennan JC (1972) Osteotomy-excision of the spine for lumbar kyphosis in older children with myelomeningocele. J Bone Joint Surg 54B:50–60

    Google Scholar 

  42. Lindseth RE, Stelzer L (1979) Vertebral excision for kyphosis in children with myelomeningocele. J Bone Joint Surg 61A:699–704

    Google Scholar 

  43. McCall RE (1998) Modified Luque instrumentation after myelomeningocele kyphectomy. Spine 23:1406–1411

    Article  PubMed  CAS  Google Scholar 

  44. Nolden MT, Sarwark JF, Vora A et al (2002) A kyphectomy technique with reduced perioperative morbidity for myelomeningocele kyphosis. Spine 27:1807–1813

    Article  PubMed  Google Scholar 

  45. Niall DM, Dowling FE, Fogarty EE et al (2004) Kyphectomy in children with myelomeningocele. A long-term outcome study. J Pediatr Orthop 24:37–44

    PubMed  CAS  Google Scholar 

  46. Heydermann JS, Gillespie R (1987) Management of myelomeningocelekyphosis in the older child by kyphectomy and segmental spinal instrumentation. Spine 12:37–41

    Article  Google Scholar 

  47. Hall JE, Poitra B (1977) The management of kyphosis in patients with myelomeningocele. Clin Orthop 128:33–40

    PubMed  Google Scholar 

  48. Eyring EJ, Wanken JJ, Sayers MP (1972) Spinal osteotomy for kyphosis in myelomeningocele. Clin Orthop 88:24–30

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Division of Pediatric Neurosurgery Marmara University Medical Center and Department of Neurosurgery, Acibadem University School of Medicine, Istanbul, Turkey

    M. Memet Özek

  2. Department of Orthopaedics and Traumatology, Marmara University Medical Center, Istanbul, Turkey

    Bülent Erol

  3. Department of Orthopaedic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Junichi Tamai

Authors
  1. M. Memet Özek
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  2. Bülent Erol
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  3. Junichi Tamai
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Memet Özek, M., Erol, B., Tamai, J. (2008). Management of Vertebral Problems and Deformities. In: The Spina Bifida. Springer, Milano. https://doi.org/10.1007/978-88-470-0651-5_26

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  • DOI: https://doi.org/10.1007/978-88-470-0651-5_26

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-0650-8

  • Online ISBN: 978-88-470-0651-5

  • eBook Packages: MedicineMedicine (R0)

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