Skip to main content
Log in

Posterior spinal fusion in patients with Ehlers–Danlos syndrome: a report of six cases

  • Original Clinical Article
  • Published:
Journal of Children's Orthopaedics

Abstract

Purpose

There is a paucity of literature describing posterior spinal fusion (PSF) in the Ehlers–Danlos syndrome (EDS) patient. The vast majority of these studies diagnosed EDS clinically. The purpose of this study is to discuss the management and complications of EDS patients with scoliosis treated with PSF at a single institution.

Methods

Clinical and radiographic data are presented describing six patients who had PSF for EDS. The diagnoses were confirmed by a geneticist.

Results

All of the patients in the current cohort underwent posterior fusion only, with no anterior approach. Neuromonitoring was also used in the majority. Half of our patients experienced complications. One patient had a hemoperitoneum that was initially treated nonoperatively but, unfortunately, they expired 1 month after discharge from abdominal bleeding. Another patient suffered neuropathic pain attributed to the type of implant used. A third underwent a total of seven procedures beginning at the age of 3 years in a different era of spinal surgery. The mean major curve, percentage correction, and estimated blood loss of the current cohort are similar to previous studies.

Conclusion

The fragility of the EDS patient population cannot be overlooked. Despite a conservative surgical approach, half of our patients experienced complications. The surgeon choosing to operate on EDS patients must do so with extreme caution.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Beighton P, De Paepe A, Steinmann B et al (1998) Ehlers–Danlos syndromes: revised nosology, Villefranche, 1997. Ehlers–Danlos National Foundation (USA) and Ehlers–Danlos Support Group (UK). Am J Med Genet 77(1):31–37

    Article  CAS  Google Scholar 

  2. McMaster MJ (1994) Spinal deformity in Ehlers–Danlos syndrome. Five patients treated by spinal fusion. J Bone Joint Surg Br 76(5):773–777

    CAS  Google Scholar 

  3. Akpinar S, Gogus A, Talu U et al (2003) Surgical management of the spinal deformity in Ehlers–Danlos syndrome type VI. Eur Spine J 12(2):135–140

    Google Scholar 

  4. Vogel LC, Lubicky JP (1996) Neurologic and vascular complications of scoliosis surgery in patients with Ehlers–Danlos syndrome. A case report. Spine 21(21):2508–2514

    Article  CAS  Google Scholar 

  5. Yang JS, Sponseller PD, Yazici M et al (2009) Vascular complications from anterior spine surgery in three patients with Ehlers–Danlos syndrome. Spine 34(4):E153–E157

    Article  Google Scholar 

  6. Padberg AM, Wilson-Holden TJ, Lenke LG et al (1998) Somatosensory- and motor-evoked potential monitoring without a wake-up test during idiopathic scoliosis surgery. An accepted standard of care. Spine 23(12):1392–1400

    Article  CAS  Google Scholar 

  7. Walick KS, King JT, Johnston CE et al (2008) Neuropathic lower extremity pain following Dunn–McCarthy instrumentation. Spine 33(23):E877–E890

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Brien Michael Rabenhorst.

About this article

Cite this article

Rabenhorst, B.M., Garg, S. & Herring, J.A. Posterior spinal fusion in patients with Ehlers–Danlos syndrome: a report of six cases. J Child Orthop 6, 131–136 (2012). https://doi.org/10.1007/s11832-012-0393-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11832-012-0393-3

Keywords

Navigation