RESULTS OF COMPENSATING SPINE FUSION IN CHILDREN WITH SPINE DEFORMITIES ASSOCIATED WITH VERTEBRAL SEGMENTATION DISORDER OF THE THORACIC SPINE
https://doi.org/10.14531/ss2009.4.8-14
Abstract
Objective. To analyze results of compensating spine fusion in children aged 1 to 3 years with vertebral segmentation disorders of the thoracic spine.
Materials and Methods. Forty children with asymmetric (lateral) segmentation disorder in the thoracic spine underwent anterior-lateral fusion on the side opposite to a vertebral block. In 3 children the fusion was supplemented with rib synostosis on the side opposite to vertebral block. Dynamics of the primary curve, thoracic spine sagittal alignment, deformity progression rate before and after surgery, and changes in left and right hemithorax volumes, SAL index and thorax asymmetry index were followed up.
Results. Mean rates of deformity progression correlate with the extension of congenital block and the amount of segments included in compensating spine fusion. Progression rate decreased by more than 50 % in 10 children having the number of surgically fused segments exceeding the number of congenitally unsegmented vertebrae. In 8 children with equal number of congenitally and artificially blocked segments the rate of deformity progression decreased by 44 %. Compensating spondylosyndesis did not influence the thorax deformity.
Conclusion. The rate of spinal deformity progression after compensating spine fusion depends on the length of unsegmented rod and the number of artificially blocked segments on the opposite side.
About the Authors
Eduard Vladimirovich Ulrikh
St. Petersburg State Pediatric Medical Academy
Russian Federation
Russian Federation
Sergey Olegovich Ryabykh
St. Petersburg State Medical University n.a. acad. I.P. Pavlov
Russian Federation
Russian Federation
References
1. Закревский Л.К. Переднебоковой спондилодез при сколиозе. Л., 1976.
2. Иткина З.Д. Сколиоз на почве аномалии позвоночника у детей: Дис.. канд. мед. наук. М., 1975.
3. Мацкевич П.Д., Шевченко С.Д. Врожденные сколиозы и их лечение // Ортопед., травматол. и протезир. 1977. Вып. 7. С. 20–24.
4. Михайловский М.В., Фомичев Н.Г. Хирургия деформаций позвоночника. Новосибирск, 2002.
5. Ульрих Э.В., Цветкова Г.В. Корригирующие операции при сколиозогенных нарушениях сегментации позвонков у детей // Актуальные вопросы современной хирургии детского возраста. Новосибирск, 1988. С. 90.
6. Ульрих Э.В. Аномалии позвоночника у детей. СПб., 1995.
7. Ульрих Э.В., Мушкин А.Ю. Хирургическое лечение пороков развития позвоночника у детей. СПб., 2007.
8. Ульрих Э.В., Рябых С.О. Деформации позвоночника на фоне нарушения сегментации у новорожденных и детей первого полугодия жизни // Хирургия позвоночника. 2008. № 1. С. 24–31.
9. Цивьян Я.Л. Хирургия позвоночника. М., 1966.
10. Цивьян Я.Л. Передний спондилодез при сколиозе // Ортопед., травматол. 1985. № 7. С. 56–60.
11. Чаклин В.Д. Костная пластика. М., 1971.
12. Чаклин В.Д., Альбасова Е.А. Сколиозы и кифозы. М., 1973.
13. Arlet V., Odent T., Aebi M. Congenital scoliosis // Eur Spine J. 2003. Vol. 12. P. 456–463.
14. Campbell R.M., Smith M.D., Mayes T.C., et al. The characteristics of thoracic insufficiency syndrome associated with fused ribs and congenital scoliosis // J. Bone Joint Surg. Am. 2003. Vol. 85. P. 399–408.
15. Dubousset J., Katti E., Seringe R. Epiphysiodesis of the spine in young children for congenital spinal deformations // J. Pediatr. Orthop. Part B. 1993. Vol. 1. P. 123–130.
16. Gotze H.G. [Prognosis and therapy of the congenital scoliosis] // Z. Orthop. Ihre Grenzgeb. 1978. Vol. 116. P. 258–266.
17. Keller P.M., Lindseth R.E, DeRosa G.P. Progressive congenital scoliosis treatment using a transpedicular anterior and posterior convex hemiepiphysiodesis and hemiarthrodesis. A preliminary report // Spine. 1994. Vol. 19. P. 1933–1939.
18. Kieffer J., Dubousset J. Combined anterior and posterior convex epiphysiodesis for progressive congenital scoliosis in children aged < or = 5 years // Eur. Spine. J. 1994. Vol. 3. P.120–125.
19. MacEwen G.D., Conway J.J., Miller W.T. Congenital scoliosis with a unilateral bar // Radiology. 1968. Vol. 90. P. 711–715.
20. MacEwen G.D., Winter R.B., Hardy J.H. Evaluation of kidney anomalies in congenital scoliosis // J. Bone Joint Surg. Am. 1972. Vol. 54. P. 1451–1454.
21. McMaster M.J. Congenital scoliosis caused by a unilateral failure of vertebral segmentation with contralateral hemivertebrae // Spine. 1998. Vol. 23. P. 998–1005.
22. Walhout R.J., van Rhijn L.W., Pruijs J.E. Hemi-epiphysiodesis for unclassified congenital scoliosis: immediate results and mid-term follow-up // Eur. Spine. J. 2002. Vol. 11. P. 543–549.
23. Winter R.B. Convex anterior and posterior hemiarthrodesis and hemiepiphyseodesis in young children with progressive congenital scoliosis // J. Pediatr. Orthop. 1981. Vol. 1. P. 361–366.
24. Winter R.B., Moe J.H. The results of spinal arthrodesis for congenital spinal deformity in patients younger than five years old // J. Bone Joint. Surg. Am. 1982. Vol. 64. P. 419–432.
Review
For citations:
Ulrikh E.V., Ryabykh S.O. RESULTS OF COMPENSATING SPINE FUSION IN CHILDREN WITH SPINE DEFORMITIES ASSOCIATED WITH VERTEBRAL SEGMENTATION DISORDER OF THE THORACIC SPINE. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2009;(4):008-014. (In Russ.) https://doi.org/10.14531/ss2009.4.8-14
Email this article 