Objective. To analyze the course of pregnancy and delivery that occurred before and after surgical correction of idiopathic scoliosis with instrumented fixation of the spine.Material and Methods. The paper presents a retrospective randomized study of 100 patients of reproductive age (18–35 years) with Lenke type 2–6 idiopathic scoliosis. The following aspects of pregnancy were analyzed: the possibility of independent conception, the pain severity according to VAS during each of the three trimesters of pregnancy, and the mode of delivery (naturally or by C-section). A comparative analysis of the data of patients operated on for the spine deformity correction before and after pregnancy and delivery was carried out. Data was collected using a questionnaire survey of patients. Detection and analysis of differences between groups were carried out using the χ 2 criterion.Results. A statistical relationship was found between the presence of instrumentation installed before delivery (during or before pregnancy) and the need for C-section. It was revealed that the lower the caudal end of instrumentation within the L3–S1 region, the higher the C-section occurrence. Predominantly thoracic scoliosis (Lenke types 2–4) is characterized by higher likelihood of independent conception and lower lumbar pain intensity during pregnancy than predominantly lumbar scoliosis (Lenke types 5–6). There are also certain difficulties in conducting spinal anesthesia in patients with installed instrumentation, which negatively affects the possibility of its use.Conclusion. The issue of the course of pregnancy and delivery in idiopathic scoliosis continues to be very significant for both patients and spine surgeons who supervise them. The solution to this issue is impossible without cooperation with obstetrician gynecologists and anesthetists planning and administering anesthetic management during delivery (which is especially important in case of impossibility or significant restriction of spinal anesthesia use in such patients).
Objective. To assess the effectiveness of the application of adhesion barrier gel Antiadgezin to prevent the development of cicatricial adhesive process and its complications in the spinal canal after decompression surgery for degenerative disease in the lumbar spine.
Objective. To describe the technique of anterior scoliosis correction in patients with completed growth and to analyze immediate results of its application.Material and Methods. Study design: retrospective clinical series. Level of evidence IV (D). A retrospective analysis of clinical and radiological data of 19 patients aged 13–44 years, who underwent anterior dynamic correction of typical idiopathic scoliosis, was performed. Patients were divided into groups as follows: Group 1 (Lenke type 1 scoliosis) – 8 patients; Group 2 (Lenke 3) – 4 patients; and Group 3 (Lenke 5) – 7 patients. When analyzing clinical and radiological data, the age was taken into account; the deformity magnitude before and after surgery, and correction angle, were studied; and intraoperative blood loss, the number of fixed levels, duration of surgery and hospital stay length were evaluated. The functional status was assessed using the VAS and the SRS-22 questionnaire. Control examinations were carried out before and after surgery as well as at 4–6 weeks and 3, 6, and 12 months after surgery. The search for statistically significant differences was carried out between all groups in pairs: between groups 1 and 2, 2 and 3, and 1 and 3. Statistical analysis was conducted using Mann – Whitney U-test. The SRS-22 and VAS data were processed using the Wilcoxon W-test.Results. The number of dynamically fixed levels varied from 6 to 12. The most proximal level of fixation was T5, the most distal – L4. The average time of surgery was 181 ± 28 minutes for transthoracic access and 198 ± 34 minutes for thoracophrenolumbotomy. The average length of hospital stay was 7.2 ± 1.5 days. In the intergroup comparison of indicators of age, mean angle of deformity before and after surgery, mean angle of correction and blood loss between groups with Lenke 1 and 3 scoliosis, no statistically significant differences were found. Comparison of the same indicators for groups with Lenke 1 and 5 scoliosis showed significant differences in the angles of deformity after surgery and in the number of fixed levels (p = 0.024 and p = 0.006, respectively). There were also no statistical differences between types 1 and 5. At 3 months after surgery the average SRS-22 score for all patients was 4.0 ± 0.42 (from 3.00 to 4.95). The VAS score changed from 6.9 ± 1.5 (4.0–9.0) before surgery to 4.4 ± 1.6 (1.0–7.0) which indicates the effectiveness of the treatment in the short term.Conclusion. Analysis of the immediate results of anterior dynamic correction of Lenke type 1, 3 and 5 scoliotic deformities in physically active young adults showed positive primary effectiveness in terms of VAS and SRS-22, which makes it possible to recommend this technique for use in the presented cohort of patients. The method is effective for all studied types of scoliosis, with a greater efficiency in Lenke types 1 and 5. Further evaluation of long-term results on a larger clinical material will allow developing more precise indications and an algorithm for application of the method.
Objective. Basing on authors' experience and literature review to analyze the concepts of surgical treatment of scoliotic deformities depending on their type, severity, and localization. Material and Methods. Three hundred and sixty six patients with scoliosis were operated on for deformity correction with dorsal CDI and anterior Hopf and Antares instrumentations. Surgical technique was chosen depending on scoliosis type, deformity severity, patient's age, and other parameters, and with the account for continuous analysis of immediate and long-term results. Thoracic scoliosis in 299 patients was treated by one-or two-stage surgery, halo-pelvic traction, and anterior release. Sixty seven patients with lumbar and thoracolumbar scoliosis underwent anterior and posterior correction with CD instrumentation. Results. Surgical treatment of severe scoliosis by singlestep multilevel discectomy and posterior correction provided a mean correction of the total angle of 40-50°. Anterior release of the spine added 40% to the achieved correction. Deformity correction in patients with lumbar and thoracolumbar scoliosis was 40 % to 90 %. Somewhat better correction of total and central angles was observed after application of anterior instrumentation. Conclusion. Differentiated approach to surgical treatment of scoliosis depending on deformity type, mobility, and severity, as well as application of anterior release, halo-pelvic traction, and modern instrumentation allows achievement of optimal correction of deformity with good radiological and clinical outcome.
Authors analysed the outcomes of surgical treatment in 108 patients with scoliosis. Depending on surgical technique the patients were divided into 4 groups. The base of surgical procedures was different combinations of Harrington distractor with Luque rod as well as with segmental angular resection at the deformity apex. The efficacy of segmental angular resection that enabled to mobilize the rigid scoliotic deformity and increase intraoperative correction was detected. The combination of that procedure with the deformity correction by Harrington distractor and lateral traction by Luque rod allowed to achieve more marked correction and to preserve it to a greater degree and for longer time (2 years after operation 67,8% of achieved correction was preserved). It was also shown that fixation of corrective spine by Harrington distractor only did not provide considerable preservation of primary achieved correction in long term postoperative period (2 years after operation 47,3% of the achieved correction was preserved).
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.