Staging surgery in treatment of complicated congenital scoliosis: report of 2 cases

Abstract

Objective To explore the feasibility and the clinical curative effect of staging surgery for pediatric complicated congenital scoliosis. Methods A retrospective study was made for 2 cases of pediatric complicated congenital scoliosis had received staging surgery from July 2006 to January 2013. The pre-operative and postoperative parameters such as coronal and sagittal balance, coronal Cobb angle, shoulder balance were measured to evaluate the therapeutic effect. Results Case A had been improved its Cobb angle from pre-operative 78° to postoperative 40° and been decreased the height difference of scapulas to 6 cm in first stage surgery, further improvement had been made for the Cobb angle was to 16° and the height difference of scapulas was to 5 cm in second stage surgery. From 6 to 8 years after surgery, the Cobb angle had been continuously improved to 16° and 10°. Case B had been improved its Cobb angle of main thoracic scoliosis from pre-operative 53° to postoperative 11°, and the lumber scoliosis had been improved from 31° to 21°, and the height difference of scapulas had been decreased to 6 cm in the first stage surgery, 1 year later lumber scoliosis increased to 30 ° and there was 8 cm coronal imbalance developed. After second stage surgery the distance from C7PL to CSVL decreased to 4 cm, and the lumber Cobb angle decreased to 3°, 1 year after the second stage surgery the lumber Cobb angle had continuously improved to 1 °, distance from C7PL to CSVL continuously decreased to 3 cm. There were no surgical complications in both cases. Conclusions Staging surgery for complicated pediatric congenital scoliosis surgery is more practical, lower risk, and better outcome. Key words: Scoliosis; Congenital abnormalities; Orthopedic procedures; Staging surgery; Child