The impact of posterior temporary internal distraction on stepwise corrective surgery for extremely severe and XXXX greater than 130  .

@entity1 @entity2003 @entity1513 @entity1635 @entity51 @entity281
AIM: To investigate the efficacy and safety of temporary internal distraction corrective surgery for extremely severe @entity1635 . METHODS: Eleven @entity1635 @entity1 (3 males and 8 females) with curves >= 130   (mean 148.8  ; range 130  -157  ) who underwent a two-stage surgery, including a posterior temporary internal distraction correction and definitive posterior spinal correction with posterior pedicle screw instrumentation from 2008 to 2011 were retrospectively reviewed. Minimum follow-up was 2-years (mean 41.8  months; range 27.0-63.0  months). The analysis focused on the impact of temporary internal distraction on curve correction, pulmonary function tests (PFTs), complications and surgical outcomes. Neurosurveillance of sensory (somatosensory-evoked potentials) and motor (motor-evoked potentials) potential was performed in all cases. Posterior instrumentation was used in all @entity1 . RESULTS: After the use of internal distraction, the preoperative major curve (mean 148.8  ; range 130  -157  ) was corrected to a mean of 79   (range 63  -87  ), the T5-T12 @entity1513 Cobb angle (mean 79  ; range 30  -97  ) was corrected to a mean of 59   (range 20  -75  ), the coronal imbalance (mean 0.8  cm; range -3.6 to 2.8  cm) was improved to a mean of 0.6  cm (range -1.5 to 2.0  cm), the forced vital capacity percentage (FVC%) was improved from 59.3      11.6 to 68.7      13.7, and the forced expiratory volume in 1  s (FEV1%) was improved from 61.4      13.6 to 71.3      9.3. The average increase in body height was 6.7  cm, and the dorsum razor was corrected to 3-5  cm. During definitive surgery, the final major curves were corrected to a mean of 55   (range 32  -72  ), the T5-T12 @entity1513 Cobb was corrected to 35   (range 15  -68  ), the coronal imbalance was improved to 0.5  cm (range -1.2 to 1.8  cm), the FVC% was improved to 71.2      8.3, the FEV1% was improved to 76.3      16.7, the increase in body height was 3.1  cm, and the dorsum razor was corrected to 1-3  cm. The mean interval time between the two surgeries was 3.5  months. None of the @entity1 exhibited @entity51 or @entity281 . No instrument complications were found during the final follow-up. CONCLUSIONS: Temporary internal distraction in a two-stage corrective surgery provided @entity1 who had extremely severe and @entity2003 , an effective and safe solution for @entity1635 without significant complications.
