Abstract
Objective. To analyze the course of pregnancy and delivery that occurred before and after surgical correction of idiopathic scoliosis with instrumented fixation of the spine.Material and Methods. The paper presents a retrospective randomized study of 100 patients of reproductive age (18–35 years) with Lenke type 2–6 idiopathic scoliosis. The following aspects of pregnancy were analyzed: the possibility of independent conception, the pain severity according to VAS during each of the three trimesters of pregnancy, and the mode of delivery (naturally or by C-section). A comparative analysis of the data of patients operated on for the spine deformity correction before and after pregnancy and delivery was carried out. Data was collected using a questionnaire survey of patients. Detection and analysis of differences between groups were carried out using the χ 2 criterion.Results. A statistical relationship was found between the presence of instrumentation installed before delivery (during or before pregnancy) and the need for C-section. It was revealed that the lower the caudal end of instrumentation within the L3–S1 region, the higher the C-section occurrence. Predominantly thoracic scoliosis (Lenke types 2–4) is characterized by higher likelihood of independent conception and lower lumbar pain intensity during pregnancy than predominantly lumbar scoliosis (Lenke types 5–6). There are also certain difficulties in conducting spinal anesthesia in patients with installed instrumentation, which negatively affects the possibility of its use.Conclusion. The issue of the course of pregnancy and delivery in idiopathic scoliosis continues to be very significant for both patients and spine surgeons who supervise them. The solution to this issue is impossible without cooperation with obstetrician gynecologists and anesthetists planning and administering anesthetic management during delivery (which is especially important in case of impossibility or significant restriction of spinal anesthesia use in such patients).
Highlights
The issue of the course of pregnancy and delivery in idiopathic scoliosis continues to be very significant for both patients and spine surgeons
The solution to this issue is impossible without cooperation with obstetrician gynecologists
Применялся ли ортопедический пояс в период беременности и послеродовом периоде? Да/нет
Summary
Федотов2 1Национальный медицинский исследовательский центр травматологии и ортопедии им. Москва, Россия 2Национальный медицинский исследовательский центр гематологии, Москва, Россия. Анализ течения беременности и родов, произошедших до и после хирургической коррекции идиопатического сколиоза с фиксацией позвоночника металлоконструкцией. Проанализированы следующие аспекты беременности: возможность самостоятельного зачатия, выраженность болевого синдрома по ВАШ в течение каждого из трех триместров беременности, а также способ родоразрешения (естественным путем либо методом кесарева сечения). Проведен сравнительный анализ данных пациенток, оперированных по поводу коррекции деформации до беременности и родов и после. Обнаружена статистическая связь между наличием металлофиксатора, установленного до родов (на протяжении беременности или до нее), и необходимостью кесарева сечения. Также присутствуют определенные сложности в проведении спинальной анестезии у пациенток с установленной металлоконструкцией, что негативно влияет на возможность ее применения. Для цитирования: Снетков А.А., Колесов С.В., Горбатюк Д.С., Пантелеев А.А., Швец В.В., Еськин Н.А., Федотов Е.А. Priorov National Medical Research Center of Traumatology and Orthopaedics, Moscow, Russia 2National Researeh Center of Hematology, Moscow, Russia
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