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BioMed Research International
Volume 2015, Article ID 481945, 6 pages
http://dx.doi.org/10.1155/2015/481945
Research Article

Minimally Invasive Scoliosis Surgery: A Novel Technique in Patients with Neuromuscular Scoliosis

1Division of Pediatric Orthopedics, Cohen Children’s Medical Center, New Hyde Park, NY 11040, USA
2Department of Orthopaedic Surgery, Children’s Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, NY 10467, USA
3Department of Pediatric Anesthesiology, Cohen Children’s Medical Center, New Hyde Park, NY 11040, USA
4Division of Pediatric Cardiology, Children’s Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, NY 10467, USA
5Division of Critical Care, Department of Pediatrics, Children’s Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, NY 10467, USA

Received 7 August 2015; Revised 6 October 2015; Accepted 15 October 2015

Academic Editor: Roberto Delfini

Copyright © 2015 Vishal Sarwahi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Minimally invasive surgery (MIS) has been described in the treatment of adolescent idiopathic scoliosis (AIS) and adult scoliosis. The advantages of this approach include less blood loss, shorter hospital stay, earlier mobilization, less tissue disruption, and relatively less pain. However, despite these significant benefits, MIS approach has not been reported in neuromuscular scoliosis patients. This is possibly due to concerns with longer surgery time, which is further increased due to more levels fused and instrumented, challenges of pelvic fixation, size and number of incisions, and prolonged anesthesia. We modified the MIS approach utilized in our AIS patients to be implemented in our neuromuscular patients. Our technique allows easy passage of contoured rods, placement of pedicle screws without image guidance, partial/complete facet resection, and all standard reduction maneuvers. Operative time needed to complete this surgery is comparable to the standard procedure and the majority of our patients have been extubated at the end of procedure, spending 1 day in the PICU and 5-6 days in the hospital. We feel that MIS is not only a feasible but also a superior option in patients with neuromuscular scoliosis. Long-term results are unavailable; however, short-term results have shown multiple benefits of this approach and fewer limitations.