Stage results of the use of orthoses in children after surgical treatment of congenital spine deformity (Preliminary report)

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Abstract


BACKGROUND: After surgical treatment of congenital spinal deformities, we can see the progression of deformities of the spinal column segments free from metal structures, which leads to the need for reoperation. Without sufficient scientific evidence, several specialists after surgical treatment use various orthoses on the body to prevent scoliotic compensatory changes.

AIM: This study aims to assess the results of body orthosis after surgical treatment of children with congenital spinal deformity with the impaired formation of the vertebrae, using orthoses, compensatory deformity after one year of treatment.

MATERIALS AND METHODS: Twenty-five patients aged 2 to 12 years (10 boys and 15 girls) after surgical treatment of congenital deformity of the spine in the thoracic regions (13) and lumbar regions (12), wearing body orthoses. The results were assessed at 3, 6, and 12 months using thermal sensors for the orthosis wearing time by X-ray and statistical methods.

RESULTS: After three months of wearing the brace, we saw a correction of about 50% of the value of the initial compensatory deformity. After six months, both thoracic and lumbar, the correction was 60%. After one year, when performing an X-ray image without an orthosis, in thoracic deformities without a brace, the correction stabilized and remained at the level of 40%. In lumbar deformities without a brace, the original deformity returned, i.e., the correction occurred but was not fixed without the orthosis. Only one of 25 patients (4%) required a second operation to increase the fixation’s duration.

CONCLUSION: The results of observing a group of patients (25 children) for one year after surgical treatment of congenital spine deformity showed a positive effect of a functionally corrective orthosis on the body to correct secondary deformities.


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About the authors

Ignatij А. Redchenko

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery; North-West Scientific and Practical Center for Rehabilitation and Prosthetics “Orthetika”

Author for correspondence.
Email: ria@scoliologic.ru
ORCID iD: 0000-0001-6055-6295
SPIN-code: 2072-1986
Scopus Author ID: 1004672

Russian Federation, Saint Petersburg; Saint Petersburg

MD, PhD Student

Sergei V. Vissarionov

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery

Email: vissarionovs@gmail.com
ORCID iD: 0000-0003-4235-5048
SPIN-code: 7125-4930

Russian Federation, Saint Petersburg

MD, PhD, D.Sc., Professor, Corresponding Member of RAS

Maxim G. Gusev

The Prosthetic and Orthopedic Center “Scoliologic.ru”

Email: llp@scoliologic.ru
ORCID iD: 0000-0002-7976-0795
Scopus Author ID: 863901

Russian Federation, Saint Petersburg

MD, PhD

Grigoriy A. Lein

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery; The Prosthetic and Orthopedic Center “Scoliologic.ru”

Email: lein@scoliologic.ru
ORCID iD: 0000-0001-7904-8688
Scopus Author ID: 863879

Russian Federation, Saint Petersburg; Saint Petersburg

MD, PhD

Ivan V. Pavlov

North-West Scientific and Practical Center for Rehabilitation and Prosthetics “Orthetika”; Small innovative enterprise “Stylian”

Email: johnkorset@yandex.ru
ORCID iD: 0000-0002-0412-6351

Russian Federation, Saint Petersburg; Saint Petersburg

MD, PhD

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Supplementary files

Supplementary Files Action
1.
Fig. 1. Scan of the patient's body (dorsal plane) and X-ray of the spine in the Rodin 4D software

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2.
Fig. 2. Completed modeling of a functional corrective orthosis on the trunk with thoracic compensatory counter-arc. On the dorsal plane on the left, the arrow indicates the pelot correcting the thoracic hibus. On the frontal cut on the right, the arrow also indicates the corrective pad. The corset borders are represented by an orange outline, the body - blue

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3.
Fig. 3. An example of a graph of temperature curves obtained on the Orthotimer, average wearing time - 18 h / day

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4.
Fig. 4. Radiographs of the spine in two projections of patient V., 6 years old. Congenital kyphoscoliosis on the background of the posterolateral hemivertebra L2, after surgical treatment

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5.
Fig. 5. Radiographs of the spine of patient V., 6 years old. Congenital kyphoscoliosis on the background of the posterolateral hemivertebra L2: a - after 6 months. in a functional corrective corset; b - after 12 months. standing without corset

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Copyright (c) 2021 Redchenko I.А., Vissarionov S.V., Gusev M.G., Lein G.A., Pavlov I.V.

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