Comparison of subtransverse process wiring and sublaminar wiring in the treatment of idiopathic thoracic scoliosis


Akmeşe R., Kemal Us A. K.

Journal of Spinal Disorders and Techniques, cilt.26, sa.2, ss.79-86, 2013 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 26 Sayı: 2
  • Basım Tarihi: 2013
  • Doi Numarası: 10.1097/bsd.0b013e3182372a2e
  • Dergi Adı: Journal of Spinal Disorders and Techniques
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.79-86
  • Anahtar Kelimeler: idiopathic thoracic scoliosis, neurological complication, sublaminar wiring, subtransverse process wiring
  • Ankara Üniversitesi Adresli: Evet

Özet

STUDY DESIGN: A retrospective study. OBJECTIVE: The objectives of this study were to show the advantages of an alternative segmental spinal instrumentation technique, termed subtransverse process wiring, and compare it with a sublaminar wiring technique in the treatment of idiopathic thoracic scoliosis. SUMMARY OF BACKGROUND DATA: High rates of neurological complications and the need for high experience limit the use of the sublaminar wiring technique, although it is an effective segmental spinal instrumentation technique in the treatment of scoliosis. This is the first study to correlate sublaminar wiring and subtransverse process wiring techniques clinically. METHODS: In a retrospective study, 64 patients with idiopathic thoracic scoliosis were chosen randomly. Nineteen patients were treated with subtransverse process wires (group A), and 45 patients were treated with sublaminar wires (group B). RESULTS: The mean follow-up period was 50.9 months (25 to 90 mo) in group A and 57.9 months (26 to 108 mo) in group B. The average deformity correction was 26.5 degrees (52.9%) in group A and 28.9 degrees (54.1%) in group B. The average correction loss was 2.9 degrees (17.2%) in group A and 6.4 degrees (27%) in group B. None of the patients developed neurological complications in group A. In group B, 5 (11.1%) intraoperative dural tears, 4 (8.9%) neurological deficits, and 8 (14.4%) transient dysesthesia syndromes were seen. The average operation time was 3.6 hours (3 to 4 h) in group A and 4.9 hours (3.75 to 8 h) in group B. The average replacement of blood (erythrocyte suspension) was 2.9 U (2 to 5 U) in group A and 3.1 U (2 to 6 U) in group B. CONCLUSIONS: Sublaminar wiring is a time-consuming technique with high risks of neurological complications, whereas subtransverse process wiring is an easy and neurologically safe method, which maintains effective deformity correction and stability of the correction. Copyright © 2012 by Lippincott Williams & Wilkins.