Background: The rate of scoliosis in syringomyelia patients ranges from 25 to 74.4%. In turn, syringomyelia occurs in 1.2% to 9.7% of scoliosis patients.
Aim: To evaluate outcomes of surgical correction of the scoliotic deformity in syringomyelia patients.
Materials and methods: Between 1996 and 2015, 3120 patients with scoliosis of various etiologies were treated at the Clinic for Child and Adolescent Vertebrology of the Novosibirsk Research Institute of Traumatology and Orthopedics. We conducted a retrospective analysis of syringomyelia-associated scoliosis cases that required surgical correction.
Results: Syringomyelia was found in 33 patients (1.05%) out of 3120 patients with spinal deformities of various etiologies; in 21 patients (0.9%) with idiopathic scoliosis of 2334 patients. In identifying the neurological deficit, the recommended first step is to perform neurosurgery. Nineteen patients were operated using the CDI, 4 patients underwent correction VEPTR, in 1 case instrumentation could not be established, 9 patients are undergoing treatment in the department of neurosurgery at the moment. Worsening of neurological deficits was not observed in any patient.
Conclusion: A comparison of the results of syringomyelia-associated scoliosis correction with the data of other authors was done. The choice of surgery tactics is strictly individual and depends on the size of the cavity. The result of surgical intervention is generally positive and the loss of correction by the end of follow-up is negligible.
The paper presents the experience in development and introduction of the Quality Management System (QMS) which meets the requirements of international standard ISO 9001:2000. The arrangement of quality management is a task, which integrates general management of the institution on the basis of quality ideology as a highest strategic aim. The application of international standards ISO 9000 facilitates the wide dissemination of new principles of management directed to a customer and quality of servicing, which were not peculiar to the Soviet Public Health. The QMS introduction is a scaled and complex process for any organization involving the whole its staff – from the head to the attending personnel. It must be performed stageby- stage with application of process approach technique. The result of QMS model development in Novosibirsk RITO is a transition from «as it is» condition to «as it should be» condition to eliminate revealed inadequacies. The used criteria and methods of monitoring and analysis permit to estimate the effectiveness and level of key processes of medical care and to schedule their improvement. A voluntary certification of conformance to the international standard ISO 9001:2000 is the first system task in the field of comprehensive management in Novosibirsk RITO. The standard conformance means that the achieved management level meets a minimal set of standardized requirements which reflect internationally recognized means of management for the production of medical services of guaranteed quality.
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