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Hybrid Spinal Constructs Using Sublaminar Polyester Bands in Posterior Instrumented Fusions in Children: A Series of 5 Cases

Viswanathan, Ashwin MD; Johnson, Keyne K. MD; Whitehead, William E. MD, MPH; Curry, Daniel J. MD; Luerssen, Thomas G. MD; Jea, Andrew MD

doi: 10.1227/01.NEU.0000368106.34969.FA
Clinical Studies

OBJECTIVE: The authors report the novel use of sublaminar polyester bands in posterior instrumented spinal fusions of the thoracic and lumbar spine and sacrum in 5 children. This is the first reported use of polyester bands in spinal surgery in the United States.

METHODS: The authors retrospectively reviewed the demographics and procedural data for children who underwent posterior instrumented fusion using sublaminar polyester bands.

RESULTS: Five children, ranging in age from 9 months to 18 years, underwent posterior instrumented fusion for posttrauma kyphotic deformity (1 patient), congenital scoliosis from hemivertebra anomaly (3 patients), and neuromuscular scoliosis associated with spina bifida (1 patient). There were 1 instance of lamina fracture with application and tensioning of the polyester band and 1 instance of transient worsening of proprioception with sublaminar passage of the polyester band.

CONCLUSION: Pedicle screws, laminar/pedicle/transverse process hooks, and sublaminar metal wires have been incorporated into posterior spinal constructs and widely reported and used in the thoracic and lumbar spine and sacrum with varying success. This report demonstrates the successful results of hybrid posterior spinal constructs that include sublaminar polyester bands that promise the technical ease of passing sublaminar instrumentation with the immediate biomechanical rigidity of pedicle screws and hooks.

Neuro-Spine Program, Division of Pediatric Neurosurgery, Texas Children's Hospital, Department of Neurosurgery, Baylor College of Medicine, Houston, Texas (Viswanathan) (Whitehead) (Curry) (Luerssen) (Jea)

Neuro-Spine Program, Division of Pediatric Neurosurgery, Texas Children's Hospital, Department of Neurosurgery Baylor College of Medicine Houston, Texas (Johnson)

Reprint requests: Andrew Jea, MD, Neuro-Spine Program, Texas Children's Hospital, CCC 1230.01, 12th Floor, Houston, TX 77030.

Received, December 4, 2008.

Accepted, October 17, 2009.

Copyright © by the Congress of Neurological Surgeons