Results of Surgical Tre atment of Ne uromuscular Deformiti es of the Spine

Česká verzia

Authors: M. Repko ¹; M. Krbec ¹; R. Chalo upka ¹; V. Tichý ¹; A. Šprláková- puková ²
Authors place of work: Ortopedická klinika LF MU a FN Brno ¹; Radi ologická klinika LF MU a FN Brno ²
Published in the journal: Cesk Slov Neurol N 2008; 71/104(4): 472-477
Category: Short Communication

Summary

Objective:
There is an essenti al difference between ne uromuscular deformiti es of the spine and idi opathic deformiti es in terms of their nature and therape utic appro ach. Most often, we have to do with cases of paralytic or rigid kyphoscoli osis. Associ ated deformity of the pelvis may be manifested by excessive frontal or posteri or inclinati on, obliquity, rotati on or complex deformity. Based on the type of disorder, we distinguish primarily ne uropathic and myopathic deformiti es. The go al of the article is to inform abo ut the character of deformiti es, their classificati on and therape utic opti ons, and to evalu ate the effect and safety of surgical soluti on.

Pati ent and method:
We monitored the frontal and sagital plane of the spine and pelvis in a total of 42 pati ents with different ne uromuscular disorders and scoli otic deformiti es. X- ray examinati on before and after surgery with basic statistical evalu ati on was used for objective assessment of results of surgery.

Results:
The results of the X-ray analysis of the pati ents who underwent surgery showed a very go od correcti on of scoli otic deformity which resulted in an improved positi on of the pelvis both in frontal and sagital plane. The frontal plane spine correcti on was achi eved in 54% of a total of 42 operated pati ents included in the set. An improvement in all the monitored parametres (i.e. sagittal profile, T9 tilt, sagittal tilt) was achi eved in the sagittal plane. The study bro ught evidence of a significant correcti on in pelvic obliquity in the pelvic regi on, as well as of reduced excessive horizontalizati on of the sacrum. All the correcti ons achi eved had a significant effect on the improvement of the qu ality of the pati ents’ sitting and also standing positi on.

Conclusi on:
Surgical therapy of ne uromuscular deformiti es of the spine using a combinati on of Luque and Galvestone techniques corrects scoli otic curves securing stable, compensated spine and balanced pelvis witho ut further loss of motor or sense functi ons. This way, stability of the standing positi on and walking is secured, with concomitant improvement of functi onal status of the cardi o-pulmonary apparatus and overall well‑being of the affected pati ent.

Key words:
ne uromuscular – scoli osis – obliquity of the pelvis

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