Surgical treatment of kyphosis in children with scheuermann’s diseaseusing 3D-CT navigation

Cover Page

Abstract


The purpose of the study is to describe features of the surgical technique for correction of kyphotic deformity of the spine and to analyze the results of surgical treatment of juvenile kyphosis in children with the use of 3D-CT navigation.— Materials and methods. We observed 11 patientsaged 14-17 years old (2 girls and 9 boys) with kyphoticdeformity of the spine, developed on the backgroundof Scheuermann’s disease. The deformity amount aver-aged 73,9° (60 to 90°). Surgery was performed fromthe combined access, carring out discapophysectomyand corporodesis on top of kyphosis and fixing mul-tibasic corrective metal construction. For the insertionof pedicle screws we used 3D-CT navigation.— The results. After surgery kyphosis value decreasedto 32,6° (20 to 45°), the deformity correction averaged41,3° (30 to 50°). Hybrid systems were placed in 5 pa-tients, total transpedicular fixation - in 6 children.Number of fixed vertebrae with hybrid metal construc-tions averaged 14 (13 to 15), in patients with total pediclefixation - 13 (12 to 14). In all cases we observed the correct position of pedicle support elements. Postopera- tive follow-up period was from 1 year and 5 months to5 years and 4 months, on average - 3 years 5 months. The loss of the result achieved in the long-term follow- up period was observed in patients with hybrid metal constructions and averaged 7,2° (4 to 9°).— Conclusion. The use of pedicle screws for thecorrection of juvenile kyphosis in children allows forthe effective correction of the deformity, restoring thephysiological profiles of the spine, eliminating post-operative progression of curvature, and reducing thelength of metal fixation and save the result achievedin the long-term follow-up. The use of active optical3D-CT navigation allows carring out a correct inser-tion of pedicle screws in the vertebral bodies in chil-dren with juvenile kyphosis.— Keywords: Scheuermann’s disease, juvenile ky-phosis, transpedicular fixation, navigation, children,surgical treatment.

Sergei Valentinovich Vissarionov

The Turner Institute for Children’s Orthopedics, Saint-Petersburg

Email: turner01@mail.ru
MD, PhD, professor, Deputy Director for Research and Academic Affairs, head of the department of spinal pathology and neurosurgery. FSBI “Scientific and Research Institute for Children’s Orthopedics n. a. G. I. Turner” under the Ministr y of Health of the Russian Federation. Professor of the chair pediatric traumatology, orthopedics and surgeon. State budget institution of higher education “North-Western State Medical University n. a. I. I. Mechnikov” under the Ministry of Health of the Russian Federation.

Dmitriy Nikolaevich Kokushin

The Turner Institute for Children’s Orthopedics, Saint-Petersburg

Email: turner01@mail.ru
MD, research associate of the department of spinal pathology and neurosurgery. FSBI “Scientific and Research Institute for Children’s Orthopedics n. a. G. I. Turner” under the Ministry of Health of the Russian Federation

Sergei Mikhailovich Belyanchikov

The Turner Institute for Children’s Orthopedics, Saint-Petersburg

Email: belijanchikov@list.ru
MD, PhD, chief of the department of spine pathology and neurosurgery. FSBI “Scientific and Research Institute for Children’s Orthopedics n. a. G. I. Turner” under the Ministry of Health of the Russian Federation.

Vladislav Valerievich Murashko

The Turner Institute for Children’s Orthopedics, Saint-Petersburg

MD, orthopedic and trauma surgeon of the department of spine pathology and neurosurgery. FSBI "Scientific and Research Institute for Children’s Orthopedics n. a. G. I. Turner” under the Ministry of Health of the Russian Federation

  • Виссарионов С.В., Дроздецкий А.П., Кокушин Д.Н., Белянчиков С.М. Коррекция идиопатического сколиоза у детей под контролем 3D-КТ-навигации // Хирургия позвоночника. 2012;(2):30-36.
  • Виссарионов С.В., Кокушин Д.Н., Белянчиков С.М., Мурашко В.В. Хирургическая коррекция кифозов при болезни Шейермана у детей // Хирургия позвоночника. 2013;(2):23-28.
  • Ветрилэ С.Т., Кулешов А.А., Швец В.В. и др. Оперативное лечение тяжелых деформаций позвоночника // Вестник Российской академии медицинских наук. 2008;(8):34-40.
  • Михайловский М.В., Новиков В.В., Васюра А.С., Лебедева М.Н. Коррекция кифозов на почве болезни Шейерманна // Хирургия позвоночника. 2005;(2):50-55.
  • Михайловский М.В., Сорокин А.Н., Новиков В.В., Васюра А.С., Лебедева М.Н., Губина Е.В. Результаты хирургического лечения кифозов с применением сегментарного инструментария при болезни Шейерманна // Хирургия позвоночника. 2011;27-34.
  • М.В., Сорокин А.Н., Новиков В.В., Васюра А.С. Выбор оптимального уровня дистальной фиксации для коррекции гиперкифоза при болезни Шейерманна // Хирургия позвоночника. 2012;(2):24-29.
  • Пат. № 2423943 Российская Федерация. Способ коррекции ювенильного кифоза позвоночника у детей / Виссарионов С.В., Кокушин Д.Н.; заявл. 16.12.2009; опу бл. 20.07.2011, Бюл. №. 33.
  • Райе Р.Э. Коррекция деформаций позвоночника с помощью инструментария Cotrel-Dubousset // Проблемы хирургии позвоночника и спинного мозга. Новосибирск, 1996;89-90.
  • Arlet V., Schlenzka D. Scheuermann’s kyphosis: surgical management. // Eur Spine J. 2005;14:817-827.
  • Geck M.J., Macagno A., Ponte A., Shufflebarger H.L. The Ponte procedure: posterior only treatment of Scheuermann‘s kyphosis using segmental posterior shortening and pedicle screw instrumentation. // J Spinal Disord Tech. 2007;20:586-593.
  • Grevitt M., Kamath V., Avadhani A., et al. Correction of thoracic kyphosis with Ponte osteotomy. // Eur Spine J.2010;19:351-352.
  • Koller H., Juliane Z., Umstaetter M., Meier O., Schmidt R., Hitzl W. Surgical treatment of Scheuermann’s kyphosis using a combined antero-posterior strategy and pedicle screw constructs: efficacy, radiographic and clinical outcomes in 111 cases. // Eur Spine J. 2014;23:180-191.
  • Koptan W.M., Elmiligui Y.H., Elsebaie H.B. All pedicle screw instrumentation for Scheuermann’s kyphosis correction: is it worth it? // Spine J. 2009;9:296-302.
  • Lonner B.S., Newton P., Betz R., Scharf C., O’Brien M., Sponseller P., Lenke L., Crawford A., Lowe T., Letko L., Harms J., Shufflebarger H. Operative management of Scheuermann’s kyphosis in 78 patients: radiographic outcomes, complications, and technique. // Spine (Phila Pa 1976). 2007 Nov;15;32(24):2644-52.

Views

Abstract - 493

PDF (Russian) - 230

PlumX


Copyright (c) 2015 Vissarionov S.V., Kokushin D.N., Belyanchikov S.M., Murashko V.V.

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