Advantages of using template guides in children for the correction of congenital spinal deformities and thoracic anomalies
- Authors: Toriya V.G.1, Vissarionov S.V.1, Manukovskiy V.A.2, Pershina P.A.1
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Affiliations:
- H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery
- Saint Petersburg Research Institute of Emergency Care named after I.I. Dzhanelidze
- Issue: Vol 12, No 2 (2024)
- Pages: 217-223
- Section: New technologies in trauma and orthopedic surgery
- Submitted: 17.05.2024
- Accepted: 17.06.2024
- Published: 27.06.2024
- URL: https://journals.eco-vector.com/turner/article/view/632132
- DOI: https://doi.org/10.17816/PTORS632132
- ID: 632132
Cite item
Abstract
BACKGROUND: In children, progressive congenital deformities of the thoracic spine combined with thoracic anomalies require surgical intervention to correct the curvature and prevent further progression during the child’s growth. Surgical correction of congenital deformity caused by segmentation disorders of the lateral surfaces of the vertebral bodies with unilateral rib synostosis aims at full correction of the existing curvature using the transpedicular spinal system and is an effective and reliable treatment option for these patients. However, this technology requires precise and correct installation of the supporting elements of the metal structure to exclude possible irreversible complications. A solution is the use of template guides in the installation of the support elements of the spinal metal structure.
AIM: This study aimed to conduct a comparative analysis of the results of using template guides for the placement of transpedicular screws with the free-hand method in children during surgical correction of congenital spinal deformities combined with thoracic anomalies.
MATERIALS AND METHODS: The results of surgical treatment of 20 patients, aged 3–9 years, were analyzed retrospectively to compare the time and accuracy of spinal metal support element placement with and without the use of template guides. The data collected included demographic information, time of bone canal formation, accuracy of spinal transpedicular screw placement, and various complications.
RESULTS: Compared with the free-hand method, the use of template guides in the surgical correction of congenital spinal deformities combined with thoracic anomalies in children reduces the time of bone canal formation and increases the accuracy of metal screw placement. These results confirm the efficacy and safety of using template guides during spinal surgery in children with these congenital malformations.
CONCLUSIONS: The use of template guides is an effective and reliable method of inserting transpedicular metal screws in the correction of congenital spinal deformities combined with thoracic anomalies in children, which increases the accuracy of implantation of support elements and reduces the surgical time. These results confirm the necessity of using template guides in the correction of congenital spinal deformities in children.
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About the authors
Vakhtang G. Toriya
H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery
Author for correspondence.
Email: vakdiss@yandex.ru
ORCID iD: 0000-0002-2056-9726
SPIN-code: 1797-5031
MD
Russian Federation, Saint PetersburgSergei V. Vissarionov
H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery
Email: vissarionovs@gmail.com
ORCID iD: 0000-0003-4235-5048
SPIN-code: 7125-4930
MD, PhD, Dr. Sci. (Med.), Professor, Corresponding Member of RAS
Russian Federation, Saint PetersburgVadim A. Manukovskiy
Saint Petersburg Research Institute of Emergency Care named after I.I. Dzhanelidze
Email: manukovskiy@emergency.spb.ru
ORCID iD: 0000-0003-0319-814X
SPIN-code: 4323-4555
MD, PhD, Dr. Sci. (Med.), Professor, Honored Doctor of the Russian Federation
Russian Federation, Saint PetersburgPolina A. Pershina
H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery
Email: polinaiva2772@gmail.com
ORCID iD: 0000-0001-5665-3009
SPIN-code: 2484-9463
MD, resident
Russian Federation, Saint PetersburgReferences
- Arlet V, Odent T, Aebi M. Congenital scoliosis. Eur Spine J. 2003;12(5):456–463. doi: 10.1007/s00586-003-0555-6
- Kæjr I. Neuro-osteology. Crit Rev Oral Biol Med. 1998;9(2):224–244. doi: 10.1177/10454411980090020501
- Braun S, Brenneis M, Schönnagel L, et al. Surgical treatment of spinal deformities in pediatric orthopedic patients. Life (Basel). 2023;13(6):1341. doi: 10.3390/life13061341
- Vissarionov SV, Asadulaev MS, Orlova EA, et al. Assessment of the efficacy of treatment for children with congenital scoliosis with unsegmented bar and rib synostosis. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2022;10(3):211–221. EDN: ZKBSJO doi: 10.17816/PTORS109182
- Ruf M. Surgical treatment of congenital scoliosis. Oper Orthop Traumatol. 2024;36(1):4–11. doi: 10.1007/s00064-023-00827-5
- Mackel CE, Jada A, Samdani AF, et al. A comprehensive review of the diagnosis and management of congenital scoliosis. Child’s Nervous System. 2018;34(11):2155–2171. doi: 10.1007/s00381-018-3915-6
- Deveza LR, Chhabra BN, Heydemann J, et al. Comparison of baseline characteristics and postoperative complications in neuromuscular, syndromic and congenital scoliosis. J Pediatr Orthop Part B. 2023;32(4):350–356. doi: 10.1097/bpb.0000000000000996
- Vissarionov SV. Surgical treatment of segmental instability of the thoracic and lumbar spine in children [dissertation abstract]. Novosibirsk; 2008. EDN: NKKLJB
- Cao J, Zhang X, Liu H, et al. 3D printed templates improve the accuracy and safety of pedicle screw placement in the treatment of pediatric congenital scoliosis. BMC Musculoskelet Disord. 2021;22(1):1014. doi: 10.1186/s12891-021-04892-4
- Gertzbein SD, Robbins SE. Accuracy of pedicular screw placement in vivo. Spine (Phila Pa 1976). 1990;15(1):4–11. doi: 10.1097/00007632-199001000-00004
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