S rod fixation to the sacrum in patients with neuromuscular spinal deformities.

A new form of pelvic fixation has been designed for use in patients with neuromuscular spinal deformities to overcome the problems imposed by the Galveston technique. One end of a Luque rod is prebent into an S shaped configuration and placed over the sacral ala supplying firm fixation across the lumbosacral junction without crossing the sacroiliac joint. It fixes firmly against the sacral ala by distracting against a hook or screw in the lumbar spine.

Management of neuromuscular scoliosis.

Neuromuscular scoliosis is classified as a neuropathic or myopathic type. Cerebral palsy is the most common form of neuropathic type, and Duchenne's muscular dystrophy best characterizes the principles and recommended treatment for the myopathic type. Nonoperative measures rarely fully control a progressive scoliosis.

Segmental spinal dysgenesis: a report of three cases.

Segmental spinal dysgenesis is an uncommon congenital spinal defect characterized by localized segmental agenesis of the upper lumbar or thoracolumbar spine. Bony defects include significant focal canal stenosis, hypoplastic or absent vertebrae, subluxation of the spinal column, and instability. The distal bony architecture is usually normal but may be bifid.

The use of total circulatory arrest in the surgery of giant hemangioma and Klippel-Trenaunay syndrome in neonates.

Two neonates required deep hypothermia and circulatory arrest to provide a central control of blood loss for the resection of giant cavernous hemangiomas. Both infants were placed on cardiopulmonary bypass, cooled to 16 degrees, and exsanguinated before resection of these peripheral lesions. The surgery was done as a lifesaving measure in both instances because both infants were suffering from high-output cardiac failure.

Long scoliosis fusion to the sacrum in adults with nonparalytic scoliosis. An improved method.

The first 17 adults with nonparalytic scoliosis having long fusion to the sacrum treated with the Luque-Galveston technique were reviewed. There were 3 men and 14 women. Their average age at the time of surgery was 47 years and the mean follow-up period was 42 months.

Air embolism in spinal surgery.

We present two cases of fatal venous air embolism that occurred in previously healthy adolescents during posterior spine fusion and instrumentation for scoliosis. Previously recorded cases in the literature have been rare and only briefly discussed. Air embolism has been a complication noted in the anesthesia and neurosurgical literature, occurring primarily in total hip patients and those patients undergoing neurosurgical procedures in a sitting position.

Luque fixation to the sacral ala using the Dunn-McCarthy modification.

The Galveston-Luque technique of fixation to the pelvis requires solid bone and a strong pelvis. Because the majority of neuromuscular patients who require fixation to the pelvis have a weak and thin illum, an alternative to the Galveston technique was sought. A technique of rod contouring was developed that takes advantage of the reliable, stout bone of the sacral ala for fixation.