Abstract
Objective. To describe the original technical surgical procedure simplifying the correction of kyphosis in children due to instrumental distraction of the anterior column of the spine, to analyze its effectiveness in the setting of clinical series. Level of evidence – IV. Material and Methods. The study included 9 patients aged 7 months to 14 years (median age: 4 years 8 months) with angular kyphosis (median magnitude 53°, min – 38°, max – 80°) associated with tuberculous (n = 4) and non-specific (n = 4) spondylitis and with a sequelae of spinal cord injury (n = 1). Deformity correction was achieved using temporary instrumental interbody distraction followed by anterior fusion with titanium mesh cage filled with autologous bone graft during a single-step two-stage reconstruction and stabilization surgery. Results. The duration of surgery was 3 hours 2 min ± 44 min, the volume of blood loss – 190 ml ± 39 ml. In all cases, the deformity was corrected by 75–85 % with restoration of physiological thoracic kyphosis and spinal profile. Conclusion. A safe and effective technique for intraoperative anterior instrumental distraction can be used to correct angular kyphosis in children, including infants.
Highlights
To describe the original technical surgical procedure simplifying the correction of kyphosis in children due to instrumental distraction of the anterior column of the spine, to analyze its effectiveness in the setting of clinical series
Modified pedicle subtraction osteotomies (mPSO) for thoracolumbar post-tubercular kyphosis in pediatric patients: retrospective clinical cases and review of the literature
Summary
To describe the original technical surgical procedure simplifying the correction of kyphosis in children due to instrumental distraction of the anterior column of the spine, to analyze its effectiveness in the setting of clinical series. A safe and effective technique for intraoperative anterior instrumental distraction can be used to correct angular kyphosis in children, including infants. Anterior correction of angular kyphosis in children: description of the technique and analysis of clinical series. 2) продолжительность операции от 180 до 450 мин; 3) риск неврологических осложнений, достигающий 30 % за счет травматичности манипуляции и повреждения спинно-мозговых корешков, в том числе их планируемого пересечения для полноценного доступа к передней колонне; 4) значительная редукция длины позвоночника за счет многоуровневой резекции задней колонны (как минимум, на протяжении патологически измененных позвонков); 5) длительная протяженная задняя инструментальная фиксация, необходимая для формирования полноценных переднего и заднего костных блоков. Цель исследования – описание оригинального технического операционного приема, упрощающего коррекцию кифоза у детей за счет инструментальной дистракции передней колонны позвоночника, анализ его эффективности в рамках клинической серии. В рамках данной публикации приводится описание метода, анализ его непосредственных, ближайших и отсроченных результатов
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