Clinical and radiological results of kyphectomy and sliding growing rod surgery technique performed in children with myelomeningocele

Abstract

Background: The aim of this study was to present clinical and radiological results of myelomeningocele (MMC) patients treated with the sliding growing rod (SGR) technique after kyphectomy. Methods: Between 2016 and 2019, 30 patients (21 males and nine females) who underwent the SGR technique with kyphectomy and posterior instrumentation due to MMC were retrospectively reviewed. Patients’ pre- and postoperative kyphosis, scoliosis, correction rates, bleeding during surgery, blood supply during and after surgery, operation time, instrumentation levels, number of vertebrae removed, MMC onset levels, hospital stay, annual lengthening amounts, and complications were evaluated. Results: The mean patient age was 6.9 (4–10) years. Mean preoperative kyphosis was 115° (87–166°), mean early postoperative kyphosis was 3.9° (20–10°), and final follow-up postoperative kyphosis was 5.1° (22–8°). In nine patients presenting with scoliosis, scoliosis was evaluated as 60.2° (115–35°) preoperative, as 12.9° (32–0°) early postoperative, and 15.7° (34–0°) in the final measurement. The kyphotic deformity correction rate was 96.5%, and the scoliotic deformity correction rate was 74.9%. A statistically significant difference was seen between pre- and early postoperative values in kyphosis and scoliosis measurements (p < 0.05). The annual prolongation of the patients was calculated as averages of 0.72 and 0.77 cm/year between T1–T12 and T1–S1, respectively. Conclusion: Kyphectomy performed during the early MMC period patients appears to be an excellent method for facilitating rehabilitation and daily care of these patients. It appears that the SGR technique, which provides lung volume protection and lengthening with kyphectomy, is a safe and reliable method in patients. Level of evidence: Level 4