Immediate and Long-term Outcomes of Surgical Treatment of Patients with Super Severe Idiopathic Scoliosis

Mikhailovsky, Mikhail; Tsivyan, Orthopaedics n.a. Ya.L.; Lebedeva, Maya; Sadovaya, Tatyana; Gubina, E. V.; Sarnadsky, Vladimir; Tsivyan, Russia Orthopaedics n.a. Ya.L.

doi:10.14531/ss2009.2.38-47

Cited by 4 publications

(3 citation statements)

References 6 publications

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“…В англоязычной литературе «тяжелыми» формами сколиоза принято считать искривления, при которых величина основной дуги колеблется в пределах 70-90° [2,3]. В отечественной литературе тяжелыми (или запущенными) формами идиопатического сколиоза считаются искривления с величиной дуги, превышающей 90° по Cobb, при этом выделено понятие «сверхтяжелых» форм сколиоза, к которым относятся деформации свыше 120° по Cobb [4]. В последние десятилетия в лечении детей с тяжелыми деформациями позвоночника достигнуты значительные успехи благодаря использованию современных гибридных и транспедикулярных металлоконструкций.…”

Section: обоснованиеunclassified

Surgical correction of severe forms of idiopathic kyphoscolyosis in children

Vissarionov

Валентинович²,

Filippova

et al. 2019

Pediatr Traum Orthop Reconstr Surg

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Background. Significant results have been achieved through the use of hybrid and transpedicular metal structures. However, when spinal systems are implanted during surgery in patients with severe forms and idiopathic scoliosis, a number of limitations arise. Not only the performance of corrective maneuvers during the operation but also the creation of mobility on the top of the main arc accompany the strategies of surgical treatment. Traditionally, mobilizing discectomy at the top of the spark is performed in patients with idiopathic scoliosis. Pedicle subtractional vertebrotomy and Ponte and Smith-Petersen osteotomy are most common in neuromuscular scoliosis and spinal deformity, with a predominance of the kyphotic component. Problems with correction of extremely low and neglected forms and idiopathic scoliosis in children remain. Aim. The present study aimed to provide a comparative analysis between using transpedicular spinal systems alone and in combination with a wedge osteotomy of the apical vertebra to correct spinal deformity in children with extremely severe right-sided idiopathic thoracic scoliosis. Materials and methods. The surgical treatment results of 20 children 15 to 17 years old with extremely severe forms of right-sided idiopathic thoracic kyphoscoliosis were included in the analysis. All patients underwent standard preoperative examination, including radiology, computed tomography, magnetic resonance imaging, and neurophysiological studies. The patients were divided into two groups according to the method used during the second stage of surgical treatment correction of deformity with the transpedicular system (1) alone or (2) in combination with a wedge osteotomy of the apical vertebra. Results. Patients from the first group showed an amount of scoliotic and kyphotic component correction ranging from 25% to 62% and from 21% to 56%, respectively. In patients from the second group, who underwent additional wedge osteotomy of the apical vertebrae during the operation, correction of the scoliotic and kyphotic components ranged from 36% to 74% and from 50% to 70%, respectively. Conclusion. In children with idiopathic thoracic kyphoscoliosis, performing a wedge corpectomy of the apical vertebral body is an effective additional mobilizing component, which allows achieving significant correction of both scoliotic and kyphotic curve components, restoring the physiological profile of the spine and body balance during the surgical intervention, and maintaining the achieved result during the long-term observation period.

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Section: обоснованиеunclassified

Surgical correction of severe forms of idiopathic kyphoscolyosis in children

Vissarionov

Валентинович²,

Filippova

et al. 2019

Pediatr Traum Orthop Reconstr Surg

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“…Наличие грубейшей деформации грудной клетки, приводящей к резкому снижению вентиляционной функции легких, выраженной дислокации органов грудной полости, позволяет рассматривать показания к хирурги-ческому лечению пациентов со сверхтяжелыми кифосколиозами как жизненные [2]. Пациент К., 15 лет, с нейрофиброматозом, грудным правосторонним кифосколиозом IV ст., килевидной деформацией грудной клетки (рис.…”

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Surgical Treatment of a Patient With Extremely Severe Kyphoscoliosis Associated With Neurofibromatosis

Baklanov¹,

Shavyrin²

2013

Hir. pozvonoč.

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Центр патологии позвоночника и нейрохирургии, Салават 2 Научно-практический центр медицинской помощи детям с пороками развития черепно-лицевой области и врожденными заболеваниями нервной системы, Москва Surgical Treatment of a Patient with Extremely Severe Kyphoscoliosis Associated with Neurofibromatosis A.N. Baklanov, I.A. Shavyrin The paper presents a case of one stage surgery through posterior approach in a patient with extremely severe kyphoscoliotic deformity associated with neurofibromatosis. The performed surgery resulted in restoration of the proper trunk balance, improved lung function, and reduced neurological deficit and pain.

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“…В практике отечественных специалистов таких пациентов встречается достаточно много. Так, из 790 пациентов с идиопатическим сколиозом, оперированных в клинике детской и подростковой вертебрологии Новосибирского НИИТО в 2002-2008 гг., больные с деформациями свыше 90° по Cobb составили 29,2 % [6]. В отделении патологии позвоночника ЦИТО прооперировано более 1000 пациентов со сколиозом, больные с деформацией, превышающей 90°, составляют 20 %.…”

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Multimodal Surgical Treatment of Severe Scoliosis Using Concave Thoracoplasty

Kuleshov¹,

Лисянский²,

Vetrile³

et al. 2012

Hir. pozvonoč.

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To analyze results of multimodal surgical treatment of patients with severe scoliosis involving concave thoracoplasty. Material and Methods. A total of 40 patients aged from 12 to 31 years with spinal deformities of 70-150° were operated on with posterior CD instrumentation combined with elevating thoracoplasty on the concave side of the thorax deformity. Mean follow-up period was 2 years. Dynamics of the respiratory function was studied. Patients underwent X-ray and CT examinations of the spine, and appearance assessment. Results. The mean preoperative Cobb angle of the major thoracic curve was 101° (range: 70-150°), and postoperative-47°; postoperative correction was 54° (53 %). The loss of correction was not practically registered at the immediate and long-term follow-up. The mean preoperative Cobb angle of the compensatory lumbar curve was 50.5°, and postoperative-20.6°. The mean thoracic kyphosis was 51° before surgery and 28.7° after surgery. The mean lung vital capacity was 56.3 % before surgery, and 66.5% in 12 months after surgery. Conclusion. Concave thoracoplasty provides increased mobility of the deformity, and improvement of stabilization, cosmetic and functional results of surgical treatment of patients with severe scoliosis.

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Immediate and Long-term Outcomes of Surgical Treatment of Patients with Super Severe Idiopathic Scoliosis

Cited by 4 publications

References 6 publications

Surgical correction of severe forms of idiopathic kyphoscolyosis in children

Surgical correction of severe forms of idiopathic kyphoscolyosis in children

Surgical Treatment of a Patient With Extremely Severe Kyphoscoliosis Associated With Neurofibromatosis

Multimodal Surgical Treatment of Severe Scoliosis Using Concave Thoracoplasty

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