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[Vertebral pedicle screw-rods system for correcting paralytic scoliosis].

OBJECTIVE
To explore some operative problems of correcting paralytic scoliosis (PS) by using vertebral pedicle screws-rods system.


METHODS
From May 2000 to May 2005, 18 patients with PS were corrected by screws-rods system which were made of titanium alloy. There were 10 males and 8 females, aging from 11 to 26 years. The primary disease included poliomyelitis in 13 patients and myelodysplasia (MS) in 5 patients (2 cases for second correction) with scoliosis of an average 85 degrees Cobb angle (55-125 degrees). The pelvic obliquity was found in all patients with an average 24 degrees angle (3-55 degrees). Of the 18 patients,3 cases were given perioperative halo-pelvic traction, 2 cases were given vertebral wedge osteotomy and correction and fixation, the other patients were purely underwent the treatment of pedicle screw-rods system implants. Fusion segment at operation ranged from 6 to 15 sections, applied screws the most was 16, the fewest was 6.


RESULTS
There were no wound infections and neurologic complications, all wounds healed by the first intention. All scoliosis obtained obvious correction (P<0.001), the correction rate averaged 52.95% (44%-81%); the majority of lumbar kyphosis and pelvic obliquity were apparently corrected. The average clinical follow-up (16 cases) was 21 months (6-36 months), there was no implants failure. One patient with MS had a worse Cobb magnitude, the other patients had no curve progression (P>0.05).


CONCLUSION
The use of vertebral pedicle screwsrods fixation to multiple vertebral bodys and short segment fusion for PS, the treatment method is reliable and the outcome is satisfactory. While performing the correcting operative procedures, the spinal, pelvic and lower extremity deformities and functions should be all considered as a whole.