Email this article Surgical Treatment of Scoliosis during the Period of Uncompleted Spine Growth
- Authors: Kuleshov AA1, Vetrile ST1, Zhestkov KG2, Guseinov VG1, Vetrile MS1
-
Affiliations:
- ЦИТО
- РМАПО
- Issue: Vol 17, No 1 (2010)
- Pages: 9-16
- Section: Articles
- URL: https://journals.rcsi.science/0869-8678/article/view/47915
- DOI: https://doi.org/10.17816/vto20101719-16
- ID: 47915
Cite item
Full Text
Abstract
Outcomes of surgical treatment of 34 patients aged from 9 to 15 years (mean age
11.7 years) with basic curvature arch from 43 to 148° (99° average). In 9 patients dorsal correction and spine fixation by CD system without intervention on the vertebral bodies was performed (1st group). In 25 patients diskepiphysectomy (including thoracoscopic one in
7 patients) and interbody spondylodesis on the apex of the convex basic arch were performed prior to dorsal correction. Then halo-pelvic traction was performed for 7-10 days followed by dorsal fixation of the spine by CDI without posterior spondylodesis (2nd group). Subsequently depending on the degree of correction loss due to spine growth step-by-step corrections of the deformity were performed. After spine growth completion final instrumental correction and fixation of the spine with posterior spondylodesis were performed. In the 1st group step-by-step corrections were to be performed in 77% of cases, in 2nd group - in 28% only. It was shown that performance of diskepiphysectomy on the apex of the deformity with following correction and CD system fixation of the spine decreased the rate of postoperative spine deformity progression, eliminated asymmetric growth of vertebrae on the deformity and increased the achieved correction. In the process of patients' growth wedge shape of the vertebral bodies decreased in frontal and sagittal planes and no increase of their torsion-rotation changes occurred.
11.7 years) with basic curvature arch from 43 to 148° (99° average). In 9 patients dorsal correction and spine fixation by CD system without intervention on the vertebral bodies was performed (1st group). In 25 patients diskepiphysectomy (including thoracoscopic one in
7 patients) and interbody spondylodesis on the apex of the convex basic arch were performed prior to dorsal correction. Then halo-pelvic traction was performed for 7-10 days followed by dorsal fixation of the spine by CDI without posterior spondylodesis (2nd group). Subsequently depending on the degree of correction loss due to spine growth step-by-step corrections of the deformity were performed. After spine growth completion final instrumental correction and fixation of the spine with posterior spondylodesis were performed. In the 1st group step-by-step corrections were to be performed in 77% of cases, in 2nd group - in 28% only. It was shown that performance of diskepiphysectomy on the apex of the deformity with following correction and CD system fixation of the spine decreased the rate of postoperative spine deformity progression, eliminated asymmetric growth of vertebrae on the deformity and increased the achieved correction. In the process of patients' growth wedge shape of the vertebral bodies decreased in frontal and sagittal planes and no increase of their torsion-rotation changes occurred.
About the authors
A A Kuleshov
ЦИТО
Email: cito-spine@mail.ru
доктор мед. наук, ведущий науч. сотр. отделения патологии позвоночника ЦИТО; ЦИТО
S T Vetrile
ЦИТОпрофессор, доктор мед. наук, зав. отделением патологии позвоночника ЦИТО; ЦИТО
K G Zhestkov
РМАПОпрофессор, доктор мед. наук, зав. кафедрой торакальной хирургии РМАПО; РМАПО
V G Guseinov
ЦИТОаспирант отделения патологии позвоночника ЦИТО; ЦИТО
M S Vetrile
ЦИТОканд. мед. наук, старший науч. сотр. отделения патологии позвоночника ЦИТО; ЦИТО
References
- Гатиатулин Р.Р., Лаптинская В.С., Шубкин В.Н. и др. Хирургическое лечение сколиоза III-IV степени пластинчатыми эндокорректорами //Хирургия позвоночника. - 2006. - N 1. - С. 33-38.
- Ким Ф.Дж., Койллард К., Ралми С. и др. Влияние сегментарной транспедикулярной фиксации на активно растущий позвоночник: длительное экспериментальное исследование //Хирургия позвоночника. - 2005. - N 1. - С. 105-111.
- Корж Н.А., Мезенцев А.А. Хирургическое лечение ювенильного идиопатического сколиоза //Хирургия позвоночника. - 2009. - N 3. - С. 30-37.
- Кулешов А.А. Хирургия тяжелых форм сколиоза и функциональные особенности некоторых органов и систем: Дис. ... д-ра мед. наук. - М., 2007.
- Михайловский М.В. Хирургическое лечение ювенильного прогрессирующего сколиоза (предварительное сообщение) //Вестн. травматол. ортопед. - 1999. - N 3. - С. 41-45.
- Михайловский М.В., Новиков В.В., Васюра А.С. и др. Хирургическое лечение ювенильного прогрессирующего сколиоза (этапное сообщение) //Вестн. травматол. ортопед. - 2002. - N 3. - C. 42-46.
- Михайловский М.В. Хирургическое лечение идиопатического сколиоза у детей с завершающимся ростом скелета (11-13 лет) //Материалы симп. детских травматологов-ортопедов России с междунар. участием. - Казань, 2008. - С. 198-199.
- Поздникин Ю.И., Микиашвили А.Н., Кобызев А.Е. и др. Хирургическое лечение сколиоза у детей и подростков //Травматол. ортопед. России. - 2002. - N 3. - C. 66-69.
- Сампиев М.Т. Xирургическое лечение больных с прогрессирующими формами сколиотической болезни: Автореф. дис. ... д-ра мед. наук. - М., 2007.
- Тесаков Д.К., Воронович И.Р. Стандартизация методов лечения детей и подростков с диспластическим (идиопатическим) сколиозом //Вестн. травматол. ортопед. - 2001. - N 4. - С. 21-24.
- Acaroglu A., Alanay A., Yazici M., Surat A. The three dimensional evolution of scoliotic curvature during instrumentation without fusion in immature patients //Eur. Spine J. - 2000. - Vol. 9, N 4. - P. 291-292.
- Burton D.C., Asher M.A., Sue Min Lai. Scoliosis correction maintenance in skeletally immature patients with idiopathic scoliosis. Is anterior fusion really necessary? //Spine. - 2000. - Vol. 25, N 1. - Р. 61-68.
- Craf H., Hecquet J., Dubousset J. Dimensional appro-aches to spinal deformities. Application to the study of pediatric scoliosis //Rev. Chir. Orthop. Reparatrice Appar Mot. - 1983. - Vol. 69, N 5. - P. 407-416.
- Dubousset J. Idiopathic scoliosis in the first decade of life //Int. Congress on spine surgery, 5th. Final program. - Istanbul, 1999. - P. 27-32.
- Dubousset J. Recidive d'une scoliose lombaire et d'un basin oblique aprиs precoce: Le phenomene de villebrequin //Proceedings Group etud de la scoliose. - Lyon, 1973. - P. 62-67.
- Koop S.E. Infantile and juvenile scoliosis //Orthop. Clin. North Am. - 1988. - Vol. 19, N 2. - Р. 331-337.
- Patterson J.F., Webb J.K., Burwell R.G. Growth of the spine after segmental spinal instrumentation with and without anterior release in early onset scoliosis //J. Bone Jt Surg. - 1989. - Vol. 71B, N 1. - P. 152.
- Pratt R.K., Webb J.K., Burwell R.G., Cummings S.L. Luque trolley and convex epiphysiodesis in the management of infantile and juvenile idiopathic scoliosis //Spine. - 1999. - Vol. 24, N 15. - P. 1538-1547.
- Pratt R.K., Webb J.K., Cummings S.L. et al. Curve resolution in progressive infantile idiopathic scoliosis after Luque trolley instrumentation with anterior release and convex epiphysiodesis //J. Bone Jt Surg. - 1997. - Vol. 79B, Suppl. 3. - P. 323.
- Tello C.A. Harrington Instrumentation without arthrodesis and consecutive distraction program for young children with several spinal deformities //Orthop. Clin. North Am. - 1994. - Vol. 25, N 2. - Р. 333-351.
- Webb J., Cole A., Burwell G. Two-stage surgery for infantile, juvenile and adolescent idiopathic scoliosis (IlS, JlS, AlS): spinal growth and factors affecting prognosis //The Second Congress of EFFORT: Abstracts. - Munich, 1995. - P. 30.
- Zeller R.D. Surgical treatment of infantile and juvenile idiopathic scoliosis. - Barcelona, 2000.
