4.4 Article

Carbon fibre instrumentation for scoliosis surgery in children with spinal cord intramedullary tumours: a novel technical note

Journal

ACTA NEUROCHIRURGICA
Volume 165, Issue 1, Pages 83-88

Publisher

SPRINGER WIEN
DOI: 10.1007/s00701-022-05314-7

Keywords

Scoliosis; Pilocytic astrocytoma; Surgery; Carbon fibre; Titanium alloys

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This article describes a surgical technique for correcting scoliosis in two adolescents with intradural tumors using carbon fiber implants. The authors utilized a hybrid approach by initially manipulating the deformity with titanium implants and then replacing the construct with carbon fiber implants to maintain the deformity correction with good follow-up outlook. This technique enabled appropriate post-operative MRI evaluation of the neural structures with a reduced risk of metal artifacts.
Introduction Scoliosis in children is the most common spinal deformity seen by general practitioners, paediatricians and spinal surgeons. Progressive scoliosis can result in the development of a worsening deformity and cosmesis. Patients usually present with aesthetic concerns. Progressive scoliosis that fails conservative management may require or be offered surgical intervention. Intramedullary tumours may be associated with scoliosis. Management of patients with these dual pathologies can be challenging. Classical scoliosis instrumentation utilising titanium implants impairs post-operative MRI evaluation with metal artefacts. Carbon fibre instrumentations has the potential to reduce the imaging metal artefacts but has not been described in scoliosis correction. Methods Surgical technical note describing correction of scoliosis in two adolescents' with intradural tumours utilising carbon fibre implants. Results We developed a hybrid approach where we initially used titanium implants to manipulate the deformity then replaced the construct with carbon fibre implants in the same setting to maintain the deformity correction with good follow up outlook. Conclusion Our technique is robust, safe and replicable. It enabled appropriate post-operative MRI evaluation of the neural structures with a reduced risk of metal artefacts.

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