Проксимальные Переходные Кифозы – Актуальная Проблема Современной Вертебрологии

Михайловский, Михаил Витальевич; Сергунин, А. Ю.

doi:10.14531/ss2014.1.11-23

Cited by 6 publications

(6 citation statements)

References 9 publications

(10 reference statements)

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“…При этом изменяются как точки приложения, так и направления векторов действующих сил, величина которых находится в прямой зависимости от протяженности конструкции, степени спондилолистеза и сагиттального дисбаланса [5,9,19]. В некоторых случаях, даже при короткосегментной фиксации, проблема смежного уровня может принимать грубую форму в виде появления кифотической деформации на границе зоны спондилодеза и свободных двигательных сегментов [3]. Непосредственной причиной возникновения проксимального (proximal junctional kyphosis -PJK) и дистального (distal junctional kyphosis -DJK) переходных кифозов могут быть повреждения дисков и связок, нарушение фиксации (расшатывание) винтов в концевых позвонках, перелом тела концевого или смежного с ним позвонка [3,21].…”

Section: Discussionunclassified

“…В некоторых случаях, даже при короткосегментной фиксации, проблема смежного уровня может принимать грубую форму в виде появления кифотической деформации на границе зоны спондилодеза и свободных двигательных сегментов [3]. Непосредственной причиной возникновения проксимального (proximal junctional kyphosis -PJK) и дистального (distal junctional kyphosis -DJK) переходных кифозов могут быть повреждения дисков и связок, нарушение фиксации (расшатывание) винтов в концевых позвонках, перелом тела концевого или смежного с ним позвонка [3,21]. Во всех трех описываемых нами случаях на границе между фиксированными и нефиксированными сегментами произошел перелом крестца, что привело к развитию кифотизации на уровне S 1 -S 2 .…”

Section: Discussionunclassified

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Transverse Fracture of the Sacrum: A Rare Complication of Surgical Treatment for Spondylolisthesis

Маркин¹,

Козлов²

2015

Hir. pozvonoč.

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Section: Discussionunclassified

Transverse Fracture of the Sacrum: A Rare Complication of Surgical Treatment for Spondylolisthesis

Маркин¹,

Козлов²

2015

Hir. pozvonoč.

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“…Comparison of scoliosis diagnostic capabilities in screening of schoolchildren by computer optical topography and video rasterstereography using TODP and Formetric topographs V.N. Sarnadskiy 1 , D.Y. Batorov 2 , O.A.…”

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Comparison of scoliosis diagnostic capabilities in screening of schoolchildren by computer optical topography and video rasterstereography using TODP and Formetric topographs

Sarnadskiy¹,

Batorov²,

Shchuchkina³

2023

Hir. pozvonoč.

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Objective. To analyze the results of scoliosis diagnostics during the examination of the same group of schoolchildren by TODP and Formetriс topographs.Material and Methods. A total of 364 schoolchildren (197 girls and 167 boys, mean age 8.92 ± 1.9 years) were examined, divided into 3 age groups: 6–8 years old (n = 135, mean age 7.22 ± 0.7 years), 8–10 years old (n = 134 children, mean age 8.95 ± 0.56 years), 10–12 years old (n = 95 children, mean age 11.35 ± 1.59 years). Schoolchildren were examined in turn by computer optical topography (TODP, released in 2021, WTOPO 5.4-2021 software) and video raster stereography (Formetric 4D released in 2015, DICAM2.6.4 software). Three standard screening poses were used for TODP, and one pose with averaging 12 frames – for Formetric.Results. The obtained statistics on the distribution of topographic analogs of the Cobb angle (the angle of lateral asymmetry for TODP and the angle of scoliosis for Formetric) showed a significant discrepancy in the percentage of detected scoliosis cases: 0–5° – 50,0 % (TODP) and 4.1 % (Formetric); 5–7° – 33.8 % and 9.3 %; 7–9° – 12.4 % and 17.9 %; 9–15° – 3.8 % and 51.6 %; 15–25° – 0,0 % and 16.2 %; 25–50° – 0,0 % and 0.8 %, respectively. Clinically significant cases of scoliosis (9° or more) in the age groups was 3.7 %, 2.2 %, 6.6 % (mean – 3.8 %) for TODP and 71.1 %, 70.1 %, 63.2 % (average – 68.7 %) for Formetric. At the same time, only 14 cases of clinically significant scoliosis (from 9° to 15°), including 9 structural and 5 compensatory scoliosis, were detected by TODP, and 250 scoliosis cases (188 – from 9° to 15°, 59 – from 15° to 25°, 3 – from 25° to 37°) – by Formetric. For 9 structural scoliosis cases (according to TODP), the Formetric diagnosis coincided completely only in 2 cases and partially in 3 (55 %), and in 5 cases of compensatory scoliosis (according to TODP) it coincided completely in 3 cases and partially in 1 (80 %).Conclusion. According to the results of topographic screening of 364 schoolchildren using the TODP topograph, 3.8 % of scoliosis cases of 9° or more was detected, which corresponds to the average screening data in a number of countries around the world. Examination of the same schoolchildren using the Formetric topograph revealed 68.7 % of cases of scoliosis of 9° or more, which allows us to judge about overdiagnosis and conclude that Formetric is poorly suited for topographic screening of scoliosis in schoolchildren.

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“…Оперативное лечение больных изучаемой категории является технически сложной задачей и сопровождается высоким процентом неудовлетворительных результатов с общим количеством осложнений 24,0-61,7 % [4,5]. В структуре данных осложнений наиболее высок вес проксимального переходного кифоза и нестабильности металлоконструкции [6][7][8]. Частота возникновения проксимального переходного кифоза после оперативного лечения деформаций позвоночника варьирует от 17 до 39 % в зависимости от продолжительности наблюдения [9].…”

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Significance of various risk factors for proximal junctional kyphosis and instability of instrumentation in surgical treatment for adult spinal deformities

et al. 2021

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Objective. To analyze the significance of the influence of various risk factors on the development of proximal junctional kyphosis (PJK) and instability of instrumentation.Material and Methods. The results of surgical treatment of 382 patients with scoliotic deformities of the lumbar spine of type I and IIIb according to Aebi were analyzed. Patients were operated on through the posterior approach using the TLIF-PLIF technique with extended rigid transpedicular instrumentation. Potential risk factors influencing the development of proximal junctional kyphosis and instability of instrumentation were analyzed.Results. It was found that only three risk factors significantly affect the development of PJK: correction of lumbar lordosis more than 30° (p = 0.036) increases the likelihood of its development by 1.5 times, osteoporosis (p = 0.001) – by 2.5 times, and proximal junctionalangle ≥10° (p = 0.001) – by 3.5 times. Three factors showed a statistically significant effect on the incidence of instrumentation instability: correction of lumbar lordosis more than 30° (p = 0.034) increases the likelihood of its occurrence by 1.7 times, osteoporosis (p = 0.018) – by 1.8 times, and deviation of the sagittal vertical axis by more than 50 mm (p = 0.001) – by 3.3 times.Conclusion. The most significant risk factors for the occurrence of PJK and instability of instrumentation are osteoporosis, correction of lumbar lordosis more than 30°, an increase in the proximal junctional angle ≥10°, and an anterior deviation of sagittal vertical axis more than 50 mm. Consideration of these factors in the preoperative period, as well as during surgery, can decrease likelihood of the occurrence of PJK and instability of instrumentation.

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Проксимальные Переходные Кифозы – Актуальная Проблема Современной Вертебрологии

Cited by 6 publications

References 9 publications

Transverse Fracture of the Sacrum: A Rare Complication of Surgical Treatment for Spondylolisthesis

Transverse Fracture of the Sacrum: A Rare Complication of Surgical Treatment for Spondylolisthesis

Comparison of scoliosis diagnostic capabilities in screening of schoolchildren by computer optical topography and video rasterstereography using TODP and Formetric topographs

Significance of various risk factors for proximal junctional kyphosis and instability of instrumentation in surgical treatment for adult spinal deformities

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