Scoliosis is an abnormal curvature of the spine that can range from a minor cosmetic deformity to severe disability. In conditions that affect the neuromuscular system such as cerebral palsy and muscular dystrophies, severe and rapidly progressive scoliosis is common. These curves can be so severe that they make sitting up in a chair impossible, lead to skin breakdown, and cause pulmonary complications and pain. Surgery is often the only effective treatment and consists of a large instrumented fusion from high in the thoracic spine down to the pelvis. Neuromuscular scoliosis poses a unique challenge to spine deformity surgeons. Typical scoliosis usually contains deformity in one plane (left/right) and is relatively flexible and easily correctable. Neuromuscular scoliosis often contains extreme and relatively rigid curvature that exists in all planes: rotational, front/back, and left/right. The bony anatomy in these patient’s is also usually abnormal, with poor quality bone and altered landmarks, which makes fixation difficult.
To address this challenging area of spinal deformity surgery, DePuy Spine has launched a neuromuscular addition to their EXPEDIUM spinal fixation product line. The set includes specialized tools focused on addressing pelvic obliquity and fixation in addition to pre-contoured rods and proximal connectors. The goal of these new tools is to make neuromuscular scoliosis surgery faster, safer and more effective.
More from the press release:
DePuy Spine Inc. announces the launch of the EXPEDIUM Neuromuscular System, a new modular system of pre-contoured rods and proximal connectors, open and closed iliac screw designs and wires, designed to help surgeons address spinal and pelvic deformity in patients with neuromuscular scoliosis.
“Surgery for neuromuscular scoliosis is very challenging in that most cases require correction of a coronal, sagittal and axial deformity, including pelvic obliquity. This deformity can occur in patients with little or no muscle tone or in those with severe muscle tone and spasticity due to diseases like muscular dystrophy or cerebral palsy,” says Randal R. Betz, MD,* a pediatric orthopaedic spine surgeon from Philadelphia. “The EXPEDIUM Neuromuscular System was designed with these patients in mind.”
According to the Scoliosis Research Society (SRS), incidence of neuromuscular scoliosis ranges from 25% in people with cerebral palsy to 90% in people with Duchenne muscular dystrophy.(1) Surgery is performed in these patients to prevent further curve progression, improve sitting balance and tolerance, reduce pain and improve quality of life.
“The modularity of the EXPEDIUM Neuromuscular System allows for easy fixation to the pelvis without the need for intra-operative modification of implants or complex rod bending. It also allows for the cantilever correction of severe pelvic obliquity and spinal deformity that was previously corrected with the unit rod,” says Kirk Dabney, MD,** orthopedic surgeon and associate director of the Cerebral Palsy Program at the Alfred I. duPont Institute in Wilmington, Delaware.
“We heard from surgeons that treating neuromuscular scoliosis is a challenging part of their practice and that they needed a system designed specifically for this type of patient,” says Namal Nawana, worldwide president, DePuy Spine. “The EXPEDIUM Neuromuscular System is that system. It provides a procedural solution that simplifies the correction procedure and optimizes the time in the operating room.” The EXPEDIUM Neuromuscular System is the latest addition to the ever expanding EXPEDIUM portfolio of products for complex spine procedures. The portfolio features a variety of instruments and implants designed to enhance speed, security and simplicity in treating a wide range of spinal deformities.
Press release: DEPUY SPINE LAUNCHES NEW SYSTEM FOR NEUROMUSCULAR SCOLIOSIS