1. Latalski Michal MD, Fatyga Marek MD
23/04/12
“Eiffel Tower” Construction In Gradual Correction Of Children With Congenital Kyphosis In Myelomeningocele -
Till 7 Years Follow Up.
Latalski Michal MD, Fatyga Marek MD
Children Orthopedic Department Medical University Lublin, Poland 1

2. conflict of interest disclosure
23/04/12
conflict of interest disclosure
There is no conflict of interest for any author. 2

3. myelomeningocoele Increasing rigid hyperkyphosis; decubitus;
23/04/12
myelomeningocoele
11 y.o. girl
Increasing rigid hyperkyphosis;
decubitus;
Impossible supine position;
Huge final operation
After 1 year

4. „Eiffel Tower” configuration Double „rib – pelvis” construct
23/04/12
„Eiffel Tower” configuration
Double „rib – pelvis” construct
Distractions every 6-10 months
Aim:
protect from TIS
decrease spine deformation

5. Material 7 children - 2 males and 5 females Age: 5-9 y.o.
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Material
7 children - 2 males and 5 females
Age: 5-9 y.o.
Deformation before IP: ° (mean 115 °)
Primary correction: 40°-145° (mean 72°)
Follow up: 1-7 y-s (mean 4 y-s)
five patients further correction after distractions
two patient initial correction was maintained

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Case 1 boy 4 y.o.
77°
90°
sitting
supine

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45°
F-up 6 years
No hump
Better function
No progresion

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Case 2 girl 8 y.o.
160°
135°
Elongation test

9. Reversion to primary deformation 21%
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135
F-up 6 years
Still presence of hump
Better function
Reversion to primary deformation
21%

10. Case 3 girl 4 y.o. 135° 95° F-up 2 years Smaller hump Better function
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135°
95°
Case 3 girl 4 y.o.
F-up 2 years
Smaller hump
Better function
No progresion

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Discusion
Hardware protects from the progression of deformation during spine growth
Although correction wasn’t spectacular, it was associated with functional improvement
The younger children/smaller/flexible deformation- the better correction
After spine maturity SF is necessary- some patients probably can avoid kyphectomy

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Conclusion
This treatment seems to be an alternative only for younger patients without severe structural changes in vertebral bodies and with flexible deformation to stop further progresion.