Journal of Craniovertebral Junction and Spine

ORIGINAL ARTICLE
Year
: 2019  |  Volume : 10  |  Issue : 3  |  Page : 172--178

Surgical treatment of spinal deformities in Marfan syndrome: Long-term follow-up results using different instrumentations


Matteo Palmisani1, Eugenio Dema1, Alessandro Rava2, Rosa Palmisani3, Massimo Girardo4, Stefano Cervellati1 
1 Scoliosis and Spinal Surgery Centre, Hesperia Hospital, Modena, Italy
2 Department of Orthopaedic and Traumatology, Orthopaedic and Trauma Centre, Cittá della Salute e della Scienza di Torino and Universitá Politecnica delle Marche, Turin, Italy
3 Department of Clinical and Molecular Sciences, School of Medicine, Cittá della Salute e della Scienza di Torino and Universitá Politecnica delle Marche, Ancona, Italy
4 Department of Orthopaedic and Traumatology, Orthopaedic and Trauma Centre, Spine Surgery Unit, Cittá della Salute e della Scienza di Torino and Universitá Politecnica delle Marche, Turin, Italy

Correspondence Address:
Dr. Alessandro Rava
Department of Orthopaedic and Traumatology, Orthopaedic and Trauma Centre, Citta della Salute e della Scienza di Torino and Universita Politecnica delle Marche, University of Turin, Via Zuretti 29, 10121, Turin
Italy

Background: Scoliosis is the most frequent spinal deformity related to Marfan syndrome (MFS). Treatment with a brace is often ineffective, and surgical treatment is very challenging; many instrumentations were used along the years. Our retrospective study has the purpose of identifying the reliability of different devices in three-dimensional correction of the spine deformities in MFS. Materials and Methods: We reviewed retrospectively the records of patients surgically treated, in a single institution between 1999 and 2016, for spinal deformities in MFS. X-rays were reviewed for analyzing the magnitude of the curves in preoperative time (T0), the amount of correction in the immediate after surgery period (T1), and it's stability at follow-up (FU) (T2). The clinical outcomes were also evaluated with the Scoliosis Research Society 24. Results: A total of 21 patients with a mean age at surgery of 16 years met inclusion and exclusion criteria. Four different construct types were identified: hooks with sublaminar wires (G1), hooks and pedicle screws (G2), pedicle screws (G3), and pedicle screws with sublaminar wires (G4). The mean FU time was 8 years. The average major scoliosis curve had a mean value of 63.48° at T0 and was corrected to 28.81° at T2. Furthermore, minor curve, thoracic lordosis, and lumbar kyphosis (when associated to scoliosis) were also corrected. Student t-test showed significative differences ( P < 0.05) for all curves between T0–T1 and T0–T2 while between T1 and T2, no differences were found. We also evaluated separately the results of each instrumentation, and G3 obtained the best performances. Conclusions: Our results shows that screws may guarantee a better correction of the deformities. Level of Evidence: III


How to cite this article:
Palmisani M, Dema E, Rava A, Palmisani R, Girardo M, Cervellati S. Surgical treatment of spinal deformities in Marfan syndrome: Long-term follow-up results using different instrumentations.J Craniovert Jun Spine 2019;10:172-178


How to cite this URL:
Palmisani M, Dema E, Rava A, Palmisani R, Girardo M, Cervellati S. Surgical treatment of spinal deformities in Marfan syndrome: Long-term follow-up results using different instrumentations. J Craniovert Jun Spine [serial online] 2019 [cited 2019 Dec 11 ];10:172-178
Available from: http://www.jcvjs.com/article.asp?issn=0974-8237;year=2019;volume=10;issue=3;spage=172;epage=178;aulast=Palmisani;type=0