caa a22 4500 445831936 CHVBK 20180317145318.0 cr unu---uuuuu 170323e20110701xx s 000 0 eng 10.1007/s00586-011-1717-6 doi (NATIONALLICENCE)springer-10.1007/s00586-011-1717-6 One-stage and posterior approach for correction of moderate to severe scoliosis in adolescents associated with Chiari I malformation: is a prior suboccipital decompression always necessary? [Elektronische Daten] [Jingming Xie, Yingsong Wang, Zhi Zhao, Ying Zhang, Yongyu Si, Zhendong Yang, Luping Liu, Ning Lu] Priority of neurological decompression was regarded as necessary for scoliosis patients associated with Chiari I malformation in order to decrease the risk of spinal cord injury from scoliosis surgery. We report a retrospective series of scoliosis associated with Chiari I malformation in 13 adolescent patients and explore the effectiveness and safety of posterior scoliosis correction without suboccipital decompression. One-stage posterior approach total vertebral column resection was performed in seven patients with scoliosis or kyphosis curve >90° (average 100.1° scoliotic and 97.1° kyphotic curves) or presented with apparent neurological deficits, whereas the other six patients underwent posterior pedicle screw instrumentation for correction of spinal deformity alone (average 77.3° scoliotic and 44.0° kyphotic curves). The apex of the scoliosis curve was located at T7-T12. Mean operating time and intraoperative hemorrhage was 463min and 5,190ml in patients undergoing total vertebral column resection, with average correction rate of scoliosis and kyphosis being 63.3 and 71.1%, respectively. Mean operating time and intraoperative hemorrhage in patients undergoing instrumentation alone was 246min and 1,450ml, with the average correction rate of scoliosis and kyphosis being 60.8 and 53.4%, respectively. The mean follow-up duration was 32.2months. No iatrogenic neurological deterioration had been encountered during the operation procedure and follow-up. After vertebral column resection, neurological dysfunctions such as relaxation of anal sphincter or hypermyotonia that occurred in three patients preoperatively improved gradually. In summary, suboccipital decompression prior to correction of spine deformity may not always be necessary for adolescent patients with scoliosis associated with Chiari I malformation. Particularly in patients with a severe and rigid curve or with significant neurological deficits, posterior approach total vertebral column resection is likely a good option, which could not only result in satisfactory correction of deformity, but also decrease the risk of neurological injury secondary to surgical intervention by shortening spine and reducing the tension of spinal cord. Springer-Verlag, 2011 Scoliosis nationallicence Kyphosis nationallicence Chiari malformation nationallicence Adolescent nationallicence Corrective surgery nationallicence Xie Jingming Department of Orthopaedics, The Second Affiliated Hospital of Kunming Medical University, No.112 Kunrui Road, 650101, Kunming, Yunnan, People's Republic of China aut Wang Yingsong Department of Orthopaedics, The Second Affiliated Hospital of Kunming Medical University, No.112 Kunrui Road, 650101, Kunming, Yunnan, People's Republic of China aut Zhao Zhi Department of Orthopaedics, The Second Affiliated Hospital of Kunming Medical University, No.112 Kunrui Road, 650101, Kunming, Yunnan, People's Republic of China aut Zhang Ying Department of Orthopaedics, The Second Affiliated Hospital of Kunming Medical University, No.112 Kunrui Road, 650101, Kunming, Yunnan, People's Republic of China aut Si Yongyu Department of Anesthesia, The Second Affiliated Hospital of Kunming Medical University, No.112 Kunrui Road, 650101, Kunming, Yunnan, People's Republic of China aut Yang Zhendong Department of Orthopaedics, The Second Affiliated Hospital of Kunming Medical University, No.112 Kunrui Road, 650101, Kunming, Yunnan, People's Republic of China aut Liu Luping Department of Orthopaedics, The Second Affiliated Hospital of Kunming Medical University, No.112 Kunrui Road, 650101, Kunming, Yunnan, People's Republic of China aut Lu Ning Department of Orthopaedics, The Second Affiliated Hospital of Kunming Medical University, No.112 Kunrui Road, 650101, Kunming, Yunnan, People's Republic of China aut European Spine Journal Springer-Verlag 20/7(2011-07-01), 1106-1113 0940-6719 20:7<1106 2011 20 586 https://doi.org/10.1007/s00586-011-1717-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00586-011-1717-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Xie Jingming Department of Orthopaedics, The Second Affiliated Hospital of Kunming Medical University, No.112 Kunrui Road, 650101, Kunming, Yunnan, People's Republic of China aut NATIONALLICENCE 700 1- Wang Yingsong Department of Orthopaedics, The Second Affiliated Hospital of Kunming Medical University, No.112 Kunrui Road, 650101, Kunming, Yunnan, People's Republic of China aut NATIONALLICENCE 700 1- Zhao Zhi Department of Orthopaedics, The Second Affiliated Hospital of Kunming Medical University, No.112 Kunrui Road, 650101, Kunming, Yunnan, People's Republic of China aut NATIONALLICENCE 700 1- Zhang Ying Department of Orthopaedics, The Second Affiliated Hospital of Kunming Medical University, No.112 Kunrui Road, 650101, Kunming, Yunnan, People's Republic of China aut NATIONALLICENCE 700 1- Si Yongyu Department of Anesthesia, The Second Affiliated Hospital of Kunming Medical University, No.112 Kunrui Road, 650101, Kunming, Yunnan, People's Republic of China aut NATIONALLICENCE 700 1- Yang Zhendong Department of Orthopaedics, The Second Affiliated Hospital of Kunming Medical University, No.112 Kunrui Road, 650101, Kunming, Yunnan, People's Republic of China aut NATIONALLICENCE 700 1- Liu Luping Department of Orthopaedics, The Second Affiliated Hospital of Kunming Medical University, No.112 Kunrui Road, 650101, Kunming, Yunnan, People's Republic of China aut NATIONALLICENCE 700 1- Lu Ning Department of Orthopaedics, The Second Affiliated Hospital of Kunming Medical University, No.112 Kunrui Road, 650101, Kunming, Yunnan, People's Republic of China aut NATIONALLICENCE 773 0- European Spine Journal Springer-Verlag 20/7(2011-07-01), 1106-1113 0940-6719 20:7<1106 2011 20 586 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer