Cargando…
Minimally invasive spine surgery in the pediatric and adolescent population: A case series
BACKGROUND: There is scant literature evaluating the indications, techniques, and outcomes of minimally invasive spine (MIS) surgery undertaken for pediatric and adolescent spine pathology. Our study attempts to evaluate the safe and effective use of MIS techniques in pediatric and adolescent patien...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6000717/ https://www.ncbi.nlm.nih.gov/pubmed/29963325 http://dx.doi.org/10.4103/sni.sni_417_17 |
_version_ | 1783331825293197312 |
---|---|
author | Menger, Richard Hefner, Matthew I. Savardekar, Amey R. Nanda, Anil Sin, Anthony |
author_facet | Menger, Richard Hefner, Matthew I. Savardekar, Amey R. Nanda, Anil Sin, Anthony |
author_sort | Menger, Richard |
collection | PubMed |
description | BACKGROUND: There is scant literature evaluating the indications, techniques, and outcomes of minimally invasive spine (MIS) surgery undertaken for pediatric and adolescent spine pathology. Our study attempts to evaluate the safe and effective use of MIS techniques in pediatric and adolescent patients and to appreciate the technical nuances of MIS surgery for this age group. METHODS: Consecutive pediatric and adolescent patients undergoing elective MIS lumbar procedures, from 2008 to 2016, were retrospectively analyzed from the practice of a single fellowship-trained academic spinal neurosurgeon. Information was retrieved regarding procedure and disease pathology. Descriptive data was obtained including age, sex, body mass index (BMI), insurance coverage, smoking status, and co-morbidities. Outcome measures were recorded including intraoperative complications, revision surgery, and return-to-function. RESULTS: Sixteen patients underwent 17 surgeries. The median BMI was 29.2 (range, 20.8–41.5). Age ranged from 12 to 19 years. Nearly 20% of the patients in our series were smokers. Most patients underwent discectomy, with L5-S1 being the most common level. One patient underwent direct pars defect repair and another underwent recurrent discectomy. More than 90% of the patients were complication-free at follow-up period of 6 months. One patient had a recurrent disc herniation and another had a superficial wound infection. Overall, 82.4% patients enjoyed full return to sports such as weight lifting, gymnastics, and contact sports. One patient required pain management to help alleviate ongoing pain. Another patient required a course of outpatient rehabilitation to help with a “foot drop.” CONCLUSION: Our series illustrates the effective application of MIS techniques among carefully selected pediatric patients. Emphasis is on using a smaller (16 mm) tubular retractor and causing minimal disruption of paraspinal osseo-tendinous structures. MIS techniques can be successfully applied to the pediatric and adolescent age group. |
format | Online Article Text |
id | pubmed-6000717 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-60007172018-06-29 Minimally invasive spine surgery in the pediatric and adolescent population: A case series Menger, Richard Hefner, Matthew I. Savardekar, Amey R. Nanda, Anil Sin, Anthony Surg Neurol Int Pediatric Neurosurgery: Original Article BACKGROUND: There is scant literature evaluating the indications, techniques, and outcomes of minimally invasive spine (MIS) surgery undertaken for pediatric and adolescent spine pathology. Our study attempts to evaluate the safe and effective use of MIS techniques in pediatric and adolescent patients and to appreciate the technical nuances of MIS surgery for this age group. METHODS: Consecutive pediatric and adolescent patients undergoing elective MIS lumbar procedures, from 2008 to 2016, were retrospectively analyzed from the practice of a single fellowship-trained academic spinal neurosurgeon. Information was retrieved regarding procedure and disease pathology. Descriptive data was obtained including age, sex, body mass index (BMI), insurance coverage, smoking status, and co-morbidities. Outcome measures were recorded including intraoperative complications, revision surgery, and return-to-function. RESULTS: Sixteen patients underwent 17 surgeries. The median BMI was 29.2 (range, 20.8–41.5). Age ranged from 12 to 19 years. Nearly 20% of the patients in our series were smokers. Most patients underwent discectomy, with L5-S1 being the most common level. One patient underwent direct pars defect repair and another underwent recurrent discectomy. More than 90% of the patients were complication-free at follow-up period of 6 months. One patient had a recurrent disc herniation and another had a superficial wound infection. Overall, 82.4% patients enjoyed full return to sports such as weight lifting, gymnastics, and contact sports. One patient required pain management to help alleviate ongoing pain. Another patient required a course of outpatient rehabilitation to help with a “foot drop.” CONCLUSION: Our series illustrates the effective application of MIS techniques among carefully selected pediatric patients. Emphasis is on using a smaller (16 mm) tubular retractor and causing minimal disruption of paraspinal osseo-tendinous structures. MIS techniques can be successfully applied to the pediatric and adolescent age group. Medknow Publications & Media Pvt Ltd 2018-06-07 /pmc/articles/PMC6000717/ /pubmed/29963325 http://dx.doi.org/10.4103/sni.sni_417_17 Text en Copyright: © 2018 Surgical Neurology International http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Pediatric Neurosurgery: Original Article Menger, Richard Hefner, Matthew I. Savardekar, Amey R. Nanda, Anil Sin, Anthony Minimally invasive spine surgery in the pediatric and adolescent population: A case series |
title | Minimally invasive spine surgery in the pediatric and adolescent population: A case series |
title_full | Minimally invasive spine surgery in the pediatric and adolescent population: A case series |
title_fullStr | Minimally invasive spine surgery in the pediatric and adolescent population: A case series |
title_full_unstemmed | Minimally invasive spine surgery in the pediatric and adolescent population: A case series |
title_short | Minimally invasive spine surgery in the pediatric and adolescent population: A case series |
title_sort | minimally invasive spine surgery in the pediatric and adolescent population: a case series |
topic | Pediatric Neurosurgery: Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6000717/ https://www.ncbi.nlm.nih.gov/pubmed/29963325 http://dx.doi.org/10.4103/sni.sni_417_17 |
work_keys_str_mv | AT mengerrichard minimallyinvasivespinesurgeryinthepediatricandadolescentpopulationacaseseries AT hefnermatthewi minimallyinvasivespinesurgeryinthepediatricandadolescentpopulationacaseseries AT savardekarameyr minimallyinvasivespinesurgeryinthepediatricandadolescentpopulationacaseseries AT nandaanil minimallyinvasivespinesurgeryinthepediatricandadolescentpopulationacaseseries AT sinanthony minimallyinvasivespinesurgeryinthepediatricandadolescentpopulationacaseseries |