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Strategies for Surgical Management of Large, Stiff Spinal Deformities in Children

Neal, Kevin M. MD; Siegall, Evan MD

Journal of the American Academy of Orthopaedic Surgeons: April 2017 - Volume 25 - Issue 4 - p e70–e78
doi: 10.5435/JAAOS-D-16-00282
Review Article

Management of large, severe, stiff spinal deformities in children can be challenging. Adjunctive treatments used in conjunction with spinal osteotomy, instrumentation, and fusion can improve the ultimate degree of deformity correction. These adjunctive treatments include preoperative halo-gravity traction, intraoperative halo-femoral traction, temporary internal spinal distraction, and anterior spinal release. Each of these techniques has unique indications and individual risks. When the appropriate protocols are followed, these techniques can be safe and efficacious.

From the Department of Orthopaedic Surgery, Nemours Children’s Specialty Care, Jacksonville, FL.

Dr. Neal or an immediate family member has received royalties from OrthoPediatrics; serves as an unpaid consultant to Medtronic; and serves as a board member, owner, officer, or committee member of the American Academy of Orthopaedic Surgeons, the Pediatric Orthopaedic Society of North America, and the Scoliosis Research Society. Neither Dr. Siegall nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article.

Received April 12, 2016

Accepted November 12, 2016

© 2017 by American Academy of Orthopaedic Surgeons
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