Abstract
Objective. To perform retrospective review of the natural history of spinal deformities caused by multiple vertebral malformations and to develop an algorithm for surgical correction with regard to a leading malformation. Material and Methods. Treatment results in 94 patients aged 5 months to 33 years with congenital spinal deformities and multiple vertebral malformations were reviewed. Surgery was performed in 81 patients who were followed-up for 6 months to 5 years. Vertebral and thoracic syndromes, neurological dynamics, and functional disorders were evaluated. An algorithm for detection of the leading malformation was applied to predict a natural course of spinal deformity associated with multiple malformations and to choose a surgical approach. Results. Patients were divided into four groups depending on the type of multiple vertebral anomalies: monosegmental (isolated), polysegmental, outspread multiple, and complicated. The approach to choosing of surgical tactics was offered. Conclusion. Indications for surgical treatment of spinal deformities caused by multiple vertebral malformations appear to be life-saving. Surgical treatment for this cohort of patients may be performed only after comprehensive examination. The identification of leading malformation is necessary to determine the volume of surgical intervention.
Highlights
To perform retrospective review of the natural history of spinal deformities caused by multiple vertebral malformations and to develop an algorithm for surgical correction with regard to a leading malformation
Indications for surgical treatment of spinal deformities caused by multiple vertebral malformations appear to be life-saving
Campbell RM Jr, Smith MD, Maves TC, et al The characteristics of thoracic insufficiency syndrome associated with fused ribs and congenital scoliosis
Summary
Ретроспективный анализ течения деформаций позвоночника на фоне множественных аномалий развития и разработка подходов к хирургической коррекции в зависимости от выявленного ведущего порока. Проанализированы результаты лечения 94 пациентов в возрасте от 5 мес. До 33 лет с врожденными деформациями позвоночника на фоне множественных пороков развития позвонков. Для прогнозирования течения деформации позвоночника на фоне множественных аномалий и разработки стратегии хирургического лечения применен алгоритм выявления ведущего порока. Выделены четыре группы типов множественных аномалий позвонков: моносегментарные (изолированные), полисегментарные, распространенные множественные, осложненные. Показания к оперативному лечению деформаций на фоне множественных пороков позвоночника носят жизненный характер. Хирургическое лечение данной группы пациентов может быть реализовано только при возможности многопрофильного обследования. Для решения вопроса об объеме оперативного вмешательства необходимо выделение типа ведущего порока. Выбор хирургической тактики при врожденных деформациях позвоночника на фоне множественных пороков позвонков // Хирургия позвоночника.
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