SURGICAL TREATMENT OF CONGENITAL DEFORMATION OF THORACOLUMBAR SPINE IN CHILDREN

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Abstract


The analysis of the results of surgical treatment of 32 patients with congenital spinal de formity against lateral and posterolateral hemivertebrae in the area of the thoracolumbar junction was carried out. The patients' ages ranged from 1.2 to 4 years old, 11 boys and 21 girls. Terms of postoperative follow-up were from 2 to 10 years. The angle of scoliosis before surgery was from 26 to 52, kyphosis - from 12 to 56. Surgical intervention was performed with the combined approach in the amount of extirpation of abnormal vertebrae with surrounding disks, deformity correction with dorsal metalwork, corporodesis and posterior fusion with local bone autograft. Metal structure was removed in 1.5-2 years after surgery. Correction of scoliosis was 94-100 %, kyphotic - 82-90 %. The progression of deformation, neurological complications and joining of the dysplastic process were not observed. In assessing of the long-term results, scoliosis curve ranged from 0 to 8 (average - 4.2), kyphotic from 0 to 10 (average - 5.1). The progression of the spinal deformity with hemivertebrae in the area of the thoracolumbar transition requires early surgical elimination of the defect with a full radical correction of congenital deformation, restoration of the anatomy of the spinal canal and the physiological curves of the spine at the level of deformation with fixation of a minimum number of spinal motion segments with metal construction and bone plastic stabilization (front and posterior spinal fusion).

Sergey Valentinovich Vissarionov

FSBI «Turner Scientific and Research Institute for Children’s Orthopedics» of Russian Health Ministry; St. Petersburg North-Western state medical university n. a. I. I. Mechnikov

Email: turner01@mail.ru
MD, DMSc, deputy director for science, scientific advisor of the department of spinal pathology and neurosurgery; Pofessor of department of pediatric trauma and orthopedics

Dmitriy Nikolaevich Kokushin

FSBI «Turner Scientific and Research Institute for Children’s Orthopedics» of Russian Health Ministry

research associate at the Department of spinal pathology and neurosurgery

Sergey Mikhailovich Belyanchikov

FSBI «Turner Scientific and Research Institute for Children’s Orthopedics» of Russian Health Ministry

PhD, orthopedic and trauma surgeon at the department of spine pathology and neurosurgery

Vladislav Valerevich Murashko

FSBI «Turner Scientific and Research Institute for Children’s Orthopedics» of Russian Health Ministry

orthopedic and trauma surgeon at the department of spine pathology and neurosurgery

Kirill Alexandrovich Kartavenko

St. Petersburg North-Western state medical university n. a. I. I. Mechnikov

postgraduate student of the chair of of pediatric trauma and orthopedics

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Copyright (c) 2013 Vissarionov S.V., Kokushin D.N., Belyanchikov S.M., Murashko V.V., Kartavenko K.A.

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