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THE RESULTS OF THE SALVAGE AND THE REVISION PROCEDURES OF SPINAL DEFORMITIES TREATED WITH VARIOUS INSTRUMENTATION SYSTEMS

  • Serdar AKALIN
  • İ.Teoman BENLİ
  • Mahmut KIŞ
  • Mert TÜZÜNER
  • Erbil AYDIN
  • Mehmet ÇITAK

J Turk Spinal Surg 1995;6(1):14-18

İn the last years, the improvement in the instrumentation systems and perfection of the treatment strategie have led to decrease a great deal in pseudoarthrosis and implant failure rates in the surgical treatment of spinai deformities. İn this study, 313 cases were evaluated whom were surgically treated with various spinai implant Systems due to their spinai deformities at the İst Orthopaedic and Traumatology Ctinic of Ankara Social security Hospital betvveen December 1989 and December 1993. Of ali these 212 patients had idiopathic scoliosis and 101 had vertebral fractures. İt was determined that 101 patients had Cotrel-Dubousset İnstrumentation (CDI), 151 patients had Texas Scottish Rite Hospital (TSRH) System, 30 patients had Hartshill Rectangle Sublaminar Wiring (HR-SSW) and 31 patients had AO Internal Fixator (AOIF). İn the foilow-up period, 14 patients had superficial and deep wound infection, 19 patients had rod brekage and hook dislodgement and 7 patients had pseudoarthrosis and revision surgery. The superficial infection have been eradicated vvithout implant removal in 5 patients. The implants were removed in 9 patients whom had deep vvound infection and any ot her instrumentation vveren't per-formed as any pseudoarthrosis area have not been observed during surgery. These patients whom had implant failure were revised with TSRH crosslinked plates or CDI dominos without implant removal. İn 10 patients, a one stage posterior instrumentation or anterior release follovved by posterior instrumentation has been performed after implant removal and correction losses were significantly restored. İn the patients whom had pseudoarthrosis, a solid fusion mass has been obtained after revision surgery. İt is suggested that with appropiate planning and ade-quate fusion, implant failures and pseudoarthrosis rates can be reduced, theremore with the use of easily revised systems, and adventage can be obtained.

Keywords: Spinai Deformity, revision and salvage operations.