RT Journal Article
SR Electronic
T1 The Value of a Modified Wiltse Approach for Deformity Correction in Neuromuscular Scoliosis
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 7023
DO 10.14444/7023
A1 Kieser, David Christopher
A1 Thakar, Chrishan
A1 Cunningham, Gregory
A1 Vidakovic, Hrvoje
A1 Hammer, Niels
A1 Nnadi, Colin
YR 2020
UL https://www.ijssurgery.com/content/early/2020/04/13/7023.abstract
AB Background Wiltse approaches have been shown to reduce operative blood loss and enhance recovery in lumbar spinal surgery; however, their efficacy in neuromuscular scoliosis (NMS) deformity correction has never been assessed. Thus, the purpose of this study was to compare the outcomes of deformity correction requiring pelvic fixation in NMS performed through a Wiltse approach in contrast to a standard midline approach.Methods This is a retrospective review of 24 consecutive children with NMS undergoing deformity correction by a single surgeon in our institution. Patient demographic data, operative time, blood loss, curve correction, length of stay, and complications were recorded.Results In 16 children, the procedure was performed through a Wiltse approach and in 8 through a midline approach. There was no significant difference in age, sex, preoperative Cobb angle, or number of levels fused. Patients who underwent a Wiltse approach had significantly less blood loss yet similar curve correction. The hospital length of stay and complication rate were not significantly different between the groups.Conclusions A modified Wiltse approach can be safely used for NMS deformity correction. This approach achieves similar curve corrections to a traditional midline approach with less blood loss and no need for iliac screw connectors.Level of Evidence 3.