Corrección instrumentada de la escoliosis idiopática del adolescente y artrodesis con aloinjerto de banco

Miguel Karsaclian; Alejandro Cúneo; Sergio Rodríguez Severo; Mario Schimchak; Olga Wodowóz; Inés Álvarez

Authors

Miguel Karsaclian Universidad de la República, Facultad de Medicina, Clínica de Traumatología y Ortopedia Pediátrica, Ex Profesor Adjunto
Alejandro Cúneo Universidad de la República, Facultad de Medicina, Clínica de Traumatología y Ortopedia Pediátrica, Profesor Adjunto
Sergio Rodríguez Severo Uruguay, Ministerio de Salud Pública, Traumatólogo Asistente
Mario Schimchak Universidad de la República, Facultad de Medicina, Clínica de Traumatología y Ortopedia Pediátrica, Profesor
Olga Wodowóz Universidad de la República, Facultad de Medicina, Clínica de Traumatología y Ortopedia Pediátrica., Ex Asistente
Inés Álvarez Instituto Nacional de Donación y Trasplante de Células, Tejidos y Órganos, Directora

Keywords:

SCOLIOSIS, HOMOLOGOUS TRANSPLANTATION, SPINAL FUSION, ORTHOPEDIC FIXATION DEVICES, POSTOPERATIVE COMPLICATIONS, ADOLESCENT

Abstract

Introduction: therapeutic management of adolescent idiopathic scoliosis (AIS) is complex. Global standards have been defined based on the angular values of the spinal curves, their progressivity and skeletal maturity. Values higher than previously set control values or failure to respond to orthotic treatment determine that the treatment option for scoliosis should be instrumented arthrosesis or reduction of curvature deformity.
Objectives: to assess the results and benefits of instrumented correction of adolescent idiopathic scoliosis by correcting deformity using the Lea Plaza sublaminar frame as instrumentation and arthrodesis with bank allograft provided by the Instituto Nacional de Donación y Trasplante de Células, Tejidos y Órganos (INDT) (National Institute for the Donation and Transplantation of Cells, Tissues and Organs).
Method: we conducted a retrospective review of a series of 15 patients, carriers of adolescent idiopathic scoliosis who underwent surgery at the Servicio de Ortopedia Infantil del Centro Hospitalario Pereira Rossell (Pereira Rossell Hospital Children’s Orthopedic Service) between November 2001 and December 2005, with an average 25-month post-surgery follow-up. In all cases, the instrumentation using the Lea Plaza sublaminar frame was performed with human cadaver allograft.
Conclusions: in 12 cases, double curve patterns evidenced type II or type I King thoracic curves with 65º and 40º maximum and minimum values and maximum and minimum lumbar values of 68º and 24º. The average corrective level for thoracic curvature was 20º and 19º for the lumbar curvature. In one case, a 58º initial thoracic-lumbar angular level dropped to 22º. Two cases corresponded to dextroconvex thoracic curves. In one patient, where the initial angle was 50º, it was reduced to 25º, and a 70º value was reduced to 10º in the other patient.

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