Assessment of the efficacy of treatment for children with congenital scoliosis with unsegmented bar and rib synostosis

Vissarionov, Sergei V.; Asadulaev, Marat S.; Orlova, Elena A.; Ivanova, Polina A.; Shabunin, Anton S.; Murashko, Tatyana V.; Khardikov, Mikhail A.; Toriya, Vachtang G.; Rybinskikh, Timofey S.; Rodionova, Kristina N.; Kokushin, D.N.

doi:10.17816/ptors109182

Pediatr Traum Orthop Reconstr Surg

2022

DOI: 10.17816/ptors109182

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Assessment of the efficacy of treatment for children with congenital scoliosis with unsegmented bar and rib synostosis

Sergei V. Vissarionov

Marat S. Asadulaev²,

Elena A. Orlova³

et al.

Abstract: BACKGROUND: Treatment of children with congenital deformity with unsegmented rod and rib synostosis is an important and topical problem to date. Topical publications present the results of surgical correction efficacy and analysis of treatment complications. The extremely important aspect of treatment efficacy assessment regarding changes in the function of external respiration is still topical. AIM: This study aimed to analyze the treatment results of children with congenital scoliosis and unilateral se… Show more

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2024

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Cited by 2 publications

References 33 publications

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Method of Selecting Surgical Treatment for Children with Congenital Deformity of the Spine and Thorax

Vissarionov,

Asadulaev,

Shabunin

et al. 2024

Annals RAMS

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Introduction. Spinal anomalies are considered to be the most severe pathology of the axial skeleton. Intrauterine formation of deformity with its subsequent progression during growth is the reason for the need for surgical intervention. The prevalence of patients with congenital scoliosis in the total structure of spinal deformities is up to 2%. In terms of the malignancy of the course of the disease, children with unsegmented rod and rib synostosis represent one of the most unfavorable groups of patients. Aim. To perform a comparative analysis of the results of surgical treatment of children with congenital scoliosis with unilateral lateral vertebral segmentation disorder and rib synostosis using different techniques. Methods. The work is a monocenter cohort study of “case-control” type (III level of evidence). The design of the work is a monocenter cohort retro and prospective study. The results of surgical treatment of patients between 2010 and 2020 were analyzed. The study included 45 patients aged 3 to 7 years with the diagnosis of congenital scoliosis with unilateral lateral segmentation disorder of vertebral bodies and rib synostosis. The patients were divided into 2 groups depending on the surgical treatment method applied. In the first group (n = 24), patients underwent thoracoplasty with implantation of an individual rib/rib/vertebral distractor; in the second group (n = 21), patients underwent spinal surgery in the scope of vertebrotomy at the apex of the curvature and correction of the deformity with a multifocal spinal system. The data of medical records, as well as MSCT, radiographs, and pulse oscillometry were included in the analysis of the results. Results. Me (median) of scoliosis before treatment in group 1 patients 58.5, IQR = 19.75; after treatment — Me = 40.0, IQR = 20.0. Me of kyphosis before surgery 22, IQR = 4.5; after surgery Me = 26.0, IQR = 4.0. In the second group, Me of scoliosis before treatment 58.0, IQR = 3.0; after treatment, Me = 20.0, IQR = 6.0. Me of kyphosis before surgery 22, IQR = 2.0; after surgery Me 28.0, IQR = 4.0. When comparing MSCT data, group 1 patients showed an increase in lung tissue volume by 21% of the initial lung volume, in group 2 the increase amounted to 27%. The analysis of external respiratory function indices demonstrates improvement of reactive component indices by 21.1%, frequency dependence of resistive component by 46.4%, resistive component by 50% in group 1 patients, in group 2 there is an improvement of reactive component indices by 21.1%, resistive component by 50.9% and frequency dependence of reactive component by 46.7%. Conclusion. Corrective intervention on the spine at an early age makes it possible to achieve effective correction of the deformity; similar changes are observed both in lung volume and functional state of the respiratory system due to the mediated correction of the thorax shape.

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Method of Selecting Surgical Treatment for Children with Congenital Deformity of the Spine and Thorax

Vissarionov,

Asadulaev,

Shabunin

et al. 2024

Annals RAMS

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Advantages of using template guides in children for the correction of congenital spinal deformities and thoracic anomalies

Toriya,

Vissarionov,

Manukovskiy

et al. 2024

Pediatr Traum Orthop Reconstr Surg

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BACKGROUND: In children, progressive congenital deformities of the thoracic spine combined with thoracic anomalies require surgical intervention to correct the curvature and prevent further progression during the child’s growth. Surgical correction of congenital deformity caused by segmentation disorders of the lateral surfaces of the vertebral bodies with unilateral rib synostosis aims at full correction of the existing curvature using the transpedicular spinal system and is an effective and reliable treatment option for these patients. However, this technology requires precise and correct installation of the supporting elements of the metal structure to exclude possible irreversible complications. A solution is the use of template guides in the installation of the support elements of the spinal metal structure. AIM: This study aimed to conduct a comparative analysis of the results of using template guides for the placement of transpedicular screws with the free-hand method in children during surgical correction of congenital spinal deformities combined with thoracic anomalies. MATERIALS AND METHODS: The results of surgical treatment of 20 patients, aged 3–9 years, were analyzed retrospectively to compare the time and accuracy of spinal metal support element placement with and without the use of template guides. The data collected included demographic information, time of bone canal formation, accuracy of spinal transpedicular screw placement, and various complications. RESULTS: Compared with the free-hand method, the use of template guides in the surgical correction of congenital spinal deformities combined with thoracic anomalies in children reduces the time of bone canal formation and increases the accuracy of metal screw placement. These results confirm the efficacy and safety of using template guides during spinal surgery in children with these congenital malformations. CONCLUSIONS: The use of template guides is an effective and reliable method of inserting transpedicular metal screws in the correction of congenital spinal deformities combined with thoracic anomalies in children, which increases the accuracy of implantation of support elements and reduces the surgical time. These results confirm the necessity of using template guides in the correction of congenital spinal deformities in children.

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Assessment of the efficacy of treatment for children with congenital scoliosis with unsegmented bar and rib synostosis

Cited by 2 publications

References 33 publications

Method of Selecting Surgical Treatment for Children with Congenital Deformity of the Spine and Thorax

Method of Selecting Surgical Treatment for Children with Congenital Deformity of the Spine and Thorax

Advantages of using template guides in children for the correction of congenital spinal deformities and thoracic anomalies

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