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Scoliosis after extended hemipelvectomy
Ioannis Papanastassiou1, Patrick J Boland, Oheneba Boachie-Adjei
1Memorial Sloan-Kettering Cancer Center, Affiliated with Weill Medical College of Cornell University, New York, NY 10021, USA.
Spine
|October 27, 2010
Summary
Extended hemipelvectomy (EH) can lead to scoliosis, particularly in patients with longer survival. Spinal fixation is not recommended due to high risks; later stabilization may be considered for symptomatic cases.
Area of Science:
- Orthopedic Surgery
- Scoliosis Research
- Oncology
Background:
- Extended hemipelvectomy (EH) is a radical surgical procedure with limited data on its long-term spinal complications.
- The prevalence and severity of scoliosis post-EH require further investigation to guide treatment decisions.
Observation:
- A retrospective review of 14 patients undergoing EH over 10 years was conducted.
- Two illustrative cases highlight the development of painful, progressive scoliosis after EH.
- Risk factors for symptomatic scoliosis include disc disruption, paraspinal muscle resection, and facetectomies in ambulatory patients.
Findings:
- Scoliosis developed in a significant proportion of EH patients with longer survival.
- Three of four patients surviving over one year had curves exceeding 20°.
- Two patients required spinal fusion for curves greater than 30°, with five developing sharp-angled lumbar curves.
Implications:
- Primary spinal fixation is associated with high morbidity and mortality in EH patients.
- Delayed spinal stabilization may be a viable option for selected high-risk patients experiencing painful instability.
- Further research is needed to optimize management strategies for spinal deformities following EH.
