RESULTS OF MULTISTAGE SURGICAL TREATMENT OF SCOLIOSIS IN THE FIRST DECADE OF LIFE USING VEPTR INSTRUMENTATION
https://doi.org/10.14531/ss2017.3.8-14
Abstract
Objective. To analyze results of final surgical treatment for scoliosis in the first decade of life.
Material and Methods. In 2008–2016, a total of 95 patients with infantile and juvenile scoliosis were operated on using VEPTR instrumentation.
The final stage of surgical treatment was performed in 14 patients (9 girls, 5 boys). The average age at the start of treatment was 5.4 ± 2.1 years, average follow-up period – 2 years (6–36 months).
Results. Average value of the primary scoliotic curve before surgery was 83.0° ± 14.8°, thoracic kyphosis 41.1° ± 11.9°, lumbar lordosis 49.5° ± 4.9°. At the last follow-up average value of the primary scoliotic curve was reduced to 56.8° ± 14.1°, thoracic kyphosis to 24.5° ± 8.5°, lumbar lordosis to 38.4° ± 5.1° (p < 0.05). Space available for lung before surgery was 84.5 ± 8.7 %, after surgery 94.8 ± 6.7 %, at the last follow-up it increased to 98.6 ± 5.4 %. Complications included 9 cases of instability of implant anchors and 1 case of suppuration. There were no neurological complications.
Conclusion. Stage correction using different instrumentations is a method of choice for surgical treatment of infantile and juvenile scoliosis.
About the Authors
Mikhail V. Mikhaylovskiy
Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan
Russian Federation
DMSc, Prof., Head of Department of Children and Adolescent Spine Surgery, Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L.Tsivyan, Novosibirsk, Russia
Russian Federation
DMSc, Prof., Head of Department of Children and Adolescent Spine Surgery, Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L.Tsivyan, Novosibirsk, Russia
Vasily A. Suzdalov
Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan
Russian Federation
MD, PhD, traumatologist-orthopaedist in the Department of Children and Adolescent Spine Surgery, Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan, Novosibirsk, Russia
Russian Federation
MD, PhD, traumatologist-orthopaedist in the Department of Children and Adolescent Spine Surgery, Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan, Novosibirsk, Russia
Denis N. Dolotin
Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan
Russian Federation
MD, traumatologist-orthopaedist, Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan, Novosibirsk, Russia
Russian Federation
MD, traumatologist-orthopaedist, Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan, Novosibirsk, Russia
Tatyana N. Sadovaya
ANO «Klinika NIITO»
Russian Federation
MD, DMSc, traumatologist-orthopaedist, pediatric orthopedic centre, ANO «Klinika NIITO», Novosibirsk, Russia
Russian Federation
MD, DMSc, traumatologist-orthopaedist, pediatric orthopedic centre, ANO «Klinika NIITO», Novosibirsk, Russia
References
1. Михайловский М.В., Суздалов В.А. Хирургическое лечение пациентов со сколиозами 1-й декады жизни: обзор литературы // Хирургия позвоночника. 2016. № 2. С. 36–44. [Mikhaylovskiy MV, Suzdalov VA. Surgical treatment of patients with scoliosis in the 1st decade of life: a literature review. Hir. Pozvonoc. 2016;(2):36–44. In Russian]. DOI: http://dx.doi.org/10.14531/ss2016.2.36-44.
2. Михайловский М.В., Суздалов В.А., Садовой М.А. Хирургическое лечение пациентов со сколиозами 1-й декады жизни: обзор литературы // Хирургия позвоночника. 2016. № 3. С. 32–40. [Mikhaylovskiy MV, Suzdalov VA., Sadovoy MA. Surgical treatment of patients with scoliosis of the first decade of life: literature review. Hir. Pozvonoc. 2016;(3):32–40. In Russian]. DOI: http://dx.doi.org/10.14531/ss2016.3.32-40.
3. Михайловский М.В., Ульрих Э.В., Суздалов В.А., Долотин Д.Н., Рябых С.О., Лебедева М.Н. Инструментарий VEPTR в хирургии инфантильных и ювенильных сколиозов: первый отечественный опыт // Хирургия позвоночника. 2010. № 3. С. 31–41. [Mikhaylovskiy MV, Ulrikh EV, Suzdalov VA, Dolotin DN, Ryabykh SO, Lebedeva MN. VEPTR instrumentation in the surgery for infantile and juvenile scoliosis: first experience in Russia. Hir. Pozvonoc. 2010;(3):31–41. In Russian]. DOI: http://dx.doi.org/10.14531/ss2010.3.31-41.
4. Ульрих Э.В. Аномалии позвоночника у детей: Руководство для врачей. СПб., 1995. [Ulrikh EV. Abnormalities of the Spine in Children. St. Petersburg, 1995. In Russian].
5. Ульрих Э.В., Мушкин А.Ю. Хирургическое лечение пороков развития позвоночника у детей. СПб., 2007. [Ulrikh EV, Mushkin AYu. Surgical Treatment of Malformations of the Spine in Children. St. Petersburg, 2007. In Russian].
6. Ульрих Э.В., Рябых С.О. Результаты уравновешивающего спондилодеза у детей при деформациях позвоночника на фоне нарушения сегментации грудного отдела // Хирургия позвоночника. 2009. № 4. С. 8–14. [Ulrikh EV, Ryabykh SO. Results of compensating spine fusion in children with spine deformities associated with vertebral segmentation disorder of the thoracic spine. Hir. Pozvonoc. 2009;(4):8–14. In Russian]. DOI: http://dx.doi.org/10.14531/ss2009.4.8-14.
7. Ульрих Э.В., Цветкова Г.В. Корригирующие операции при сколиозогенных нарушениях сегментации позвонков у детей // Актуальные вопросы современной хирургии детского возраста. Новосибирск, 1988. [Ulrikh EV, Tsvetkova GV. Corrective surgery for scoliogenic disorders of vertebral segmentation in children. In: Topical Issues of Modern Pediatric Surgery. Novosibirsk, 1988. In Russian].
8. Berdan EA, Larson AN, Hess DJ, Acton RD, Ledonio CG, Seidel FG, Polly DW, Saltzman DA. Double crush to the thorax: kyphoscoliosis and pectus excavatum. AAP National Conference and Exhibition, New Orleans 20.10.2012. Section on Surgery – poster session with oral presentations. Electronic resource. URL: https://aap.confex.com/aap/2012/webprogram/Paper16241.html.
9. Campbell RM Jr, Smith MD, Mayes TC, Mangos JA, Willey-Courand DB, Kose N, Pinero RF, Alder ME, Duong HL, Surber JL. The characteristics of thoracic insufficiency syndrome associated with fused ribs and congenital scoliosis. J Bone Joint Surg Am. 2003;85:399–408.
10. Hershman SH, Park JJ, Lonner BS. Fusionless surgery for scoliosis. Bull Hosp Jt Dis. 2013;71:49-53.
11. McCalla JD, Williams BA, Matsumoto H, Akbarnia BA, Blakemore LC, Betz RR, Flynn JM, Johnston CE, McCarthy R, Roye DP, Skaggs DL, Smith JT, Snyder BD, Sponseller PD, Sturm PF, Thompson GH, Yazici M, Vitale MG. Introducing the early onset scoliosis classification system. AAP National Conference and Exhibition, New Orleans, October 20–21, 2012.
Review
For citations:
Mikhaylovskiy M.V., Suzdalov V.A., Dolotin D.N., Sadovaya T.N. RESULTS OF MULTISTAGE SURGICAL TREATMENT OF SCOLIOSIS IN THE FIRST DECADE OF LIFE USING VEPTR INSTRUMENTATION. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2017;14(3):8-14. https://doi.org/10.14531/ss2017.3.8-14
Email this article 