Modification of the Original Luque Technique in the Treatment of Duchenne's Neuromuscular Scoliosis

Abstract

Luque segmental instrumentation with Galveston technique for pelvic fixation is generally used in the correction of Duchenne's neuromuscular spinal deformities with pelvic obliquity. Particularly difficult is the control of the lumbopelvic junction. Instrumentation failures and only mediocre correction of pelvic obliquity are reported. To obtain better sacropelvic anchorage and to improve pelvic correction, this technique was modified with the introduction of sacral screws in each S-1 pedicle and a device for transverse traction between the caudal right-angle bends of the L-rods. From 1988 and 1993, 25 consecutive patients (mean age, 14 years) were operated on using this technique. Before surgery, mean spinal deformity measured 68 degrees (range, 46-90 degrees), and pelvic obliquity, 21 degrees (range, 7-45 degrees). At the last examination (mean follow-up, 36 months), mean spinal curvature was 18 degrees (range, 3-37 degrees), and pelvic obliquity was always <15 degrees (range, 0-15 degrees) with mean correction of 75%. No instrumentation failure or loss of correction >3 degrees could be observed in the entire series. In every patient, a good sitting balance could be restored after surgery.