SURGICAL TREATMENT OF L5-SPONDYLOLISTHESIS VERTEBRAE IN CHILDREN. BENEFITS OF POSTERIOR APPROACH

Cover Page
  • Authors: Vissarionov S.V.1, Murashko V.V.1, Belyanchikov S.M.1, Kokushin D.N.1, Solokhina I.Y.1, Guseva I.A.1, Murashko T.V.1, Pavlova M.S.1
  • Affiliations:
    1. FSBI “Scientific and Research Institute for Children’s Orthopedics n. a. G. I. Turner” under the Ministry of Health of the Russian Federation
  • Issue: Vol 2, No 3 (2014)
  • Pages: 24-33
  • Section: Articles
  • URL: https://journals.eco-vector.com/turner/article/view/278
  • DOI: https://doi.org/10.17816/PTORS2324-33

Abstract


Objective to develop current options of surgical treatment of L5-spondylolisthesis in children. Materials and methods: 48 patients were observed and underwent surgical treatment at age of 10-17 years. In 9 patients spondylolisthesis of L5 was grade 2, in 14 - grade 3, in 12 - grade 4. 9 patients had spondyloptosis of the body of L5-vertebra. The article presents different options of surgical treatment of spondylolisthesis in children depending on the degree of vertebrae body shift and the main clinical manifestations. During surgery the anatomy of the vertebral canal and the normal interposition in the pathological segment were reconstructed. It resulted in normalization of the body balance and regression of neurological symptoms. Results: in spondylolisthesis grade 2 and 3 full reduction was achieved. In patients with grade 4 spondylolisthesis deformity was reduced to grade 2-3. Pain and radicular syndromes regressed in 2-3 days after surgery. In patients with monoparesis and contractures regression of neurological deficit took 1-1,5 months. Conclusions: The method of surgical treatment in patients with spondylolisthesis of L5 vertebrae depends on the degree of vertebrae shifting presence of segmental instability and neurological sighns.

Sergei Valentinovich Vissarionov

FSBI “Scientific and Research Institute for Children’s Orthopedics n. a. G. I. Turner” under the Ministry of Health of the Russian Federation

Email: turner01@mail.ru
MD, PhD, DMedSc, Deputy Director for science, head of the department of spinal pathology and neurosurgery.

Vladislav Valerievich Murashko

FSBI “Scientific and Research Institute for Children’s Orthopedics n. a. G. I. Turner” under the Ministry of Health of the Russian Federation

MD, orthopedic and trauma surgeon of the department of spine pathology and neurosurgery

Sergei Mikhailovich Belyanchikov

FSBI “Scientific and Research Institute for Children’s Orthopedics n. a. G. I. Turner” under the Ministry of Health of the Russian Federation

Email: belijanchikov@list.ru
MD, PhD, orthopedic and trauma surgeon of the department of spine pathology and neurosurgery

Dmitriy Nikolaevich Kokushin

FSBI “Scientific and Research Institute for Children’s Orthopedics n. a. G. I. Turner” under the Ministry of Health of the Russian Federation

MD, research associate of the department of spinal pathology and neurosurgery

Irina Yurievna Solokhina

FSBI “Scientific and Research Institute for Children’s Orthopedics n. a. G. I. Turner” under the Ministry of Health of the Russian Federation

MD, neurologist, research associate of the department of spinal pathology and neurosurgery

Irina Anatolievna Guseva

FSBI “Scientific and Research Institute for Children’s Orthopedics n. a. G. I. Turner” under the Ministry of Health of the Russian Federation

MD, specialist of functional diagnostics

Tatyana Valerievna Murashko

FSBI “Scientific and Research Institute for Children’s Orthopedics n. a. G. I. Turner” under the Ministry of Health of the Russian Federation

MD, the radiologist of the сabinet of computed tomography

Maria Sergeevna Pavlova

FSBI “Scientific and Research Institute for Children’s Orthopedics n. a. G. I. Turner” under the Ministry of Health of the Russian Federation

MD, anesthesiologist-resuscitator

  1. Андрианов В. Л., Баиров Г. А., Садофьева В. И., Райе Р. Э. Заболевания и повреждения позвоночника у детей и подростков. Л.: Медицина, 1985. С. 256.
  2. Глазырин Д. И. Новое в диагностике и лечении спондилолистеза: методические рекомендации. Свердловск, 1981.
  3. Глазырин Д. И. Клинико-биомеханические обоснования и оценка эффективности переднего спондилолиза с редукцией позвонка при спондилолистезе: Автореф. дисс.. д-ра мед. наук. М., 1981.
  4. Грунтовский Г. Х., Продан А. И., Филиппенко В. А., Радченко В. А. Стабильно-функциональный спондилодез при повреждениях и заболеваниях позвоночника. Ортопед. травматол. Киев, 1992. С. 71-73.
  5. Дулаев А. К., Надулич К. А., Теремшонок А. В. Лечение пациентки с истинным спондилолистезом L5 позвонка IV степени. Хирургия позвоночника. 2006. № 1. С. 62-65.
  6. Миронов С.П., Ветрилэ С. Т., Ветрилэ М. С. Оперативное лечение спондилолистеза позвонка L5 с применением транспедикулярных фиксаторов. Хирургия позвоночника. 2004. № 1. С. 39-46.
  7. Хвисюк Н. И., Чикунов А. С., Арсений А. К. Дегенеративный спондилолистез. Кишинев: Картя Молдовеняскэ, 1986. С. 184.
  8. Borkow S. E., Kleiger B. Spondylolisthesis in the newborn. A case report. Clin. Ortop. 1971. Vol. 81. P. 73-76.
  9. Labelle H., Roussouly P., Berthonnaud E. Spondylolisthesis, pelvic incidence, and spinopelvic balance: a correlation study. Spine. 2004. Vol. 29, № 18. P. 2049-2054.
  10. Laurent L. E. Spondylolistesis. Nord Med. 1959. Vol. 61, № 9. P. 357-360.
  11. Takahachi K., Jamagata M., Takayanagi K. et al. Changes of the sacrum in severe spondylolisthesis: a possible key pathology of the disorder. J. Orthop. Sci. 2000. Vol. 5. P. 18-24.
  12. Taylor L.J. Severe spondylolisthesis and scoliosis in association with Marfan syndrome. Case report and review of the literature. Clin. Orthop. 1987. Vol. 221. P. 207-211.
  13. Farfan H.F., Osteria V., Lami C. The mechanical etiology of spondylolysis and spondylolisthesis. Clin. Orthop. 1976. Vol. 117. P. 40-55.
  14. Duval-Beapure G., Schmidt C., Cosson P. A Barycentremetric study of the sagittal shape of spine and pelvis: The conditions required for an economic standing position. Ann. Biomed. Eng. 1992. Vol. 20. P. 451-462.
  15. Hasegawa S., Yamamoto H., Morisawa J. et al. A study of mechanoreceptors in fibrocartilage masses in the defect of pars interarticularis. J. Orthop. Sci. 1999. Vol. 32. P. 413-420.
  16. Nazarian S. Spondylolysis and spondylolitic spondylolisthesis: a review of current concept on pathogenesis, natural history, clinical symptoms, imaging and therapeutic management. Eur. Spine J. 1992. Vol. 1. P. 62-83.
  17. Ohmori K., Ishida Y., Takatsu T. et al. Vertebral slip in lumbar spondylolysis and spondylolisthesis: Long term follow-up of 22 adult patients. J. Bone Jont Surg. Br. 1995. Vol. 77. P. 771-773.
  18. Libson E., Bloom R.A., Dinari L. Symptomatic and asymptomatic spondylolisthesis in young and adults. Int. Orthop. 1982. Vol. 6. P. 259-261.
  19. Kim N. H., Suk K. S. The role of transitional vertebrae spondylolysis and spondylolisthesis. Bull. Hosp. Jt. Dis. 1997. Vol. 56. P. 161-166.
  20. Kim S. M., Lim T. J., Paterno J. A biomechanical comparison of supplementary posterior translaminar facet and transfaceto-pedicular screw fixation after anterior lumbar interbody fusion. J. Neurosurg. Spine. 2004. Vol. 1. № 1. P. 101-107.
  21. Konz R. J., Goel V. K., Grobler L. J. et al. The pathomechanism of spondylolytic spondylolisthesis in immature primate lumbar spines in vitro and finite element assessments. Spine. 2001. Vol. 26. P. 38-49.
  22. Seitsalo S., Osterman K., Hyvarinen H. et al. Progression of spondylolisthesis in children and adolescent: a long-term follow-up on 272 patients. Spine. 1991. Vol. 16. P. 417-421.
  23. Takahachi K., Jamagata M., Takayanagi K. et al. Changes of the sacrum in sever spondylolisthesis: a possible key pathology of the disorder. J. Orthop. Sci. 2000. Vol. 5. P. 18-24.
  24. Turnpenny P. D., Alman B., Cornier A. S. Abnormal vertebral segmentation and the notch signaling pathway in man. Dev. Dyn. 2007. Vol. 236, № 6. P. 1456-1474.
  25. Vidal J., Marnay T. La morphologie et l’equilibre corporel antero-posterier dans le spondylolisthesis L5-S1. Rev. Chir. Orthop. 1983. Vol. 69. P. 17-28.
  26. Winter R. B. Classification and terminology. Moe’s textbook of scoliosis and other spinal deformities. Philadelphia: WB Saunders company, 1995. P. 39-43.

Views

Abstract - 1580

PDF (Russian) - 892

Cited-By


CrossRef     2 citations

  • Krutko AV, Sanginov AJ, Giers MB, Alshevskaya A, Moskalev AV. Surgical treatment of lower lumbar spine pathology in children and adolescents. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2018;6(4):37. doi: 10.17816/PTORS6437-47
  • Skryabin EG. Isolated and Multilevel Spondylolysis (Literature Review). Traumatology and Orthopedics of Russia. 2019;25(2):157. doi: 10.21823/2311-2905-2019-25-2-157-165

PlumX


Copyright (c) 2014 Vissarionov S.V., Murashko V.V., Belyanchikov S.M., Kokushin D.N., Solokhina I.Y., Guseva I.A., Murashko T.V., Pavlova M.S.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.