Хирургия болезни Шейерманна. Основные проблемы: несистематический обзор литературы (часть II)

Цель исследования. Анализ литературных данных по вопросам частоты развития переходных кифозов в хирургии болезни Шейерманна, их связи с показателями позвоночно-тазовых параметров, факторов риска и профилактики их развития.
Материал и методы. Поиск источников (Scopus, Web of Science) позволил обнаружить 62 статьи, опубликованных в 1975–2021 гг., содержащих искомую информацию. Из них критериям включения соответствуют 56 публикаций.
Результаты. В 56 статьях содержатся данные о 2110 пациентах. Всего было диагностировано 247 (11,8 %) проксимальных пере-
ходных кифозов, включая 6 (0,3 %) случаев несостоятельности проксимального перехода. Общее количество дистальных переходных кифозов составило 124 (5,9 %). Выполнено 45 повторных операций. Авторами публикаций выявлено множество потенциальных факторов риска, однако ни по одному из них нет единого мнения. Как следствие – отсутствие обоснованной общей позиции по вопросу о профилактике развития переходных кифозов. Показатели позвоночно-тазовых параметров при болезни Шейерманна достоверно меньше, чем в общей популяции, они не имеют тенденции к изменениям после хирургической коррекции кифоза, а что
касается их связи с риском развития проксимальных и дистальных переходных кифозов, то единого мнения на сегодняшний день не сложилось.
Заключение. Настоящий обзор – наибольший по охвату литературных источников по проблеме развития переходных кифозов в хирургии болезни Шейерманна. Причины развития этого осложнения остаются неизвестными, отсюда отсутствие общепринятых методов профилактики. Необходимы новые исследования с бóльшими сроками послеоперационного наблюдения.

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