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The results of thoracic and lumbar hemivertebrae resection by a dorsal pedicular approach in children S.O. Riabykh, A.V. Gubin, D.M. ...

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ʠ616.711.5/.6-007.24-089.87-053.2

DOI10.18019/1028-4427-2015-4-42-47

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....໠,. The results of thoracic and lumbar hemivertebrae resection by a dorsal pedicular approach in children S.O. Riabykh, A.V. Gubin, D.M. Savin, E.Iu. Filatov FederalStateBudgetaryInstitutionRussianIlizarovScientificCenterRestorativeTraumatologyandOrthopaedics(FSBIRISCRTO) oftheRFMinistryofHealth,Kurgan . . . . .58 ࠖ14 2711,2012-2015.. 3 : I , II , III .



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Design.Aretrospectiveanalysisofclinicalobservations.Purpose.Tomakearetrospectiveanalysisoftheresultsofresectinghemivertebraebythe dorsalapproachthroughtherootofthearchofthethoracicandlumbarlocalization.Materials and Methods.Thedataof58patientswiththespine deformitythroughtheleadingmalformationformationdisorderandasymmetricshapesofvertebralfusionattheagefrom14monthsto27years and11monthswhoweretreatedwithintheperiodof2012-2015.

Allthepatientsunderwentinterventionsbythedorsalpedicularapproach.Allthe surgicalinterventionsweredividedintothreegroupsbyfixationtypedependingontheextentandvariantofthespinefixation:GroupIunilateral monosegmentalfixation,GroupIIbilateralmonosegmentalfixation,GroupIIIbilateralpolysegmentalfixation.Theanalysiscriteria:deformity amountbeforeandafterthesurgicaltreatmentaccordingtoCobb,correctionpercentage,thesurgeryduration,thevolumeofbloodloss,theextent of instrumental fixation, bone block condition dynamically, the course of local deformity in the long-term periods (above two years), presence of complications. Results. In Group I deformity correction in the frontal and sagittal planes amounted to 67,4 % 90 %, respectively. In Group II thecorrectionineachoftheplaneswas72,8%88,4%.InGroupIIIthecorrectionvaluesamountedto71,2%83%inthefrontalandsagittal planes.Complicationswereobservedin7(12%)patients,beingrepresentedbyprogressionofthedeformityinthezoneofstabilization,aswellas bythedeformityofadjacentsegmentsthatrequiredre-adjustmentsoffixationsystemsandusingcorrectingvertebrotomies.Conclusion.Theradical extirpationofhemivertebraebythedorsalpedicularapproachallowsachievingcompletecorrectionofthedeformity,aswellasreducesthetimeof surgery, thenumberof the implanted elements, intraoperativeblood loss and the periods of rehabilitativetreatment.The performanceof pedicular extirpationcombinedwithbilateralfixationispreferable.

Keywords:children, spine, deformity, hemivertebrae,unilateralmonosegmentalfixation, bilateralmonosegmentalfixation, bilateralpolysegmental fixation.

   

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1. ..,..,..:// .2009.2..55-61. 2. ..,..//.2013.4..3035.

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6. Khirurgicheskoe lechenie detei s vrozhdennoi deformatsiei verkhnegrudnogo otdela pozvonochnika [Surgical treatment of children with congenital deformityoftheupperthoracicspine]/S.V.Vissarionov,D.N.Kokushin,S.M.Belianchikov,A.M.Efremov//KhirurgiiaPozvonochnika.2011.N2.S. 35-40.

7. Lumbarhemivertebraresection/G.Bollini,P.L.Docquier,E.Viehweger,F.Launay,J.L.Jouve//J.BoneJointSurg.Am.2006.Vol.88,No5.P.1043-1052.

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1990.Vol.72,No4.P.536-540.

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11.LeathermanK.D.,DicksonR.A.Two-stagecorrectivesurgeryforcongenitaldeformitiesofthespine//J.BoneJointSurg.Br.1979.Vol.61-B,No3.P. 324-328. 12.RufM.,HarmsJ.Hemivertebraresectionbyaposteriorapproach:innovativeoperativetechniqueandfirstresults//Spine.2002.Vol.27,No10.P.1116Lumbosacralhemivertebrae.Areviewoftwenty-fourpatients,withexcisionineight/P.B.Slabaugh,R.B.Winter,J.E.Lonstein,J.H.Moe//Spine.1980. Vol.5,No3.P.234-244.

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02.11.2015.

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Information about the authors:

1.RiabykhSergeiOlegovichFSBIRISCRTOoftheRFMinistryofHealth,Kurgan,HeadoftheScientificClinical-and-ExperimentalLaboratory ofAxialSkeletalPathologyandNeurosurgery,DoctorofMedicalSciences;e-mailaddress:rso_@mail.ru.

2.GubinAleksandrVadimovichFSBIRISCRTOoftheRFMinistryofHealth,Director,DoctorofMedicalSciences;e-mail:Alexander@gubin.

spb.ru.

3.SavinDmitriiMikhailovichFSBIRISCRTOoftheRFMinistryofHealth,ScientificClinical-and-ExperimentalLaboratoryofAxialSkeletal PathologyandNeurosurgery,ajuniorresearcher,HeadofDepartmentofTraumatologyandOrthopaedicsNo9. 4.FilatovEgorIur'evichFSBIRISCRTOoftheRFMinistryofHealth,apostgraduatestudent.

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