Abstract
Objective. To assess surgical treatment of children with congenital lumbar spine deformities associated with congenital developmental disorders of vertebrae and to select optimal approach to the treatment of such patients. Material and Methods. We have operated 16 patients aged from one year and 11 months to six years and three months with congenital scoliosis and kyphoscoliosis associated with developmental disorders of the lumbar vertebrae. Orthopedic status and the state of deformed spine before and after surgical intervention were evaluated based on data of clinical, neurological, and radiological examinations. Degree of immediate postoperative correction of congenital deformity and long-term outcomes after metal device removal were assessed. Results. Surgical treatment of patients younger than 3 years of age with isolated hemivertebra in the lumbar spine resulted in up to 86.0 % correction of scoliotic deformity and up to 77.5 % that of kyphotic deformity. The further child’s growth is associated with a tendency toward spontaneous correction of residual deformity. In children of four to seven years old the mean correction of scoliosis reached 80.0 %, and that of kyphosis – 87.5 %. The loss of correction was not observed during a short-time follow-up period. Conclusion. The optimal age for surgical treatment of congenital deformity in developmental vertebral disorders is the age below 3 years. Deformity correction at this age can provide a maximum approach of frontal and sagittal contours to their physiological norms.
Highlights
assess surgical treatment of children with congenital lumbar spine deformities associated with congenital developmental disorders of vertebrae
16 patients aged from one year
three months with congenital scoliosis and kyphoscoliosis associated with developmental disorders of the lumbar vertebrae
Summary
Анализ хирургического лечения детей с врожденными деформациями поясничного отдела позвоночника при нарушении формирования позвонков и выработка оптимальной тактики ведения данной категории пациентов. С врожденными сколиозом и кифосколиозом при нарушении формирования позвонков поясничного отдела. Оценены ортопедический статус и состояние деформированного позвоночника пациентов до и после оперативного вмешательства с помощью данных комплексного обследования, включающего клинический, неврологический и лучевой методы. После операции определена степень коррекции врожденной деформации, оценены отдаленные результаты после удаления металлоконструкции. При изолированных полупозвонках поясничной локализации в результате оперативного лечения у пациентов до 3 лет достигнута коррекция сколиотической деформации до 86,0 %, кифотической – до 77,5 %. Оптимальным возрастом для хирургического лечения врожденных деформаций при нарушении формирования позвонков является ранний возраст (до 3 лет), когда возможно исправление деформации, максимально приближающее фронтальный и сагиттальный профили позвоночника к физиологическим.
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