Therapy of Inborn Spine Deformities
Authors:
M. Repko; M. Krbec; J. Burda; J. Pešek; R. Chaloupka; V. Tichý; M. Leznar
Authors place of work:
Ortopedická klinika FN Brno-Bohunice
přednosta doc. MUDr. M. Krbec, CSc.
Published in the journal:
Čes-slov Pediat 2008; 63 (6): 299-305.
Category:
Original Papers
Summary
Objective:
The aim of the contribution is to compare retrospectively long-term clinical and radiological results, safety and efficiency of conservative therapy and various techniques of surgical treatment of congenital scoliosis on a unique group of patients with a more than 30-year period of observation. The authors present an analysis of all commonly used method of therapy with long-term results and the mean period of observation of 16.1 years.
Materials and methods:
In the evaluated cohort of 685 patients with congenital scoliosis and treated at the Orthopedic Clinic, Teaching Hospital Brno-Bohunice in the years 1976–2007 there were 650 patients with inborn bone deformities of the spine and 35 patients with a mixed defect in the form of diastematomyelia. In the group of bone deformities, 321 (49%) patients have been treated conservatively, 102 patients (16%) have been treated with a simple fusion, 145 (22%) others were treated with instrumental fusion from the posterior approach and 82 (13%) subjects were operated on by a combined procedure with osteotomy or hemivertebrectomy and posterior instrumentation of convexity. In the group of mixed defects 19 (54%) patients have been treated conservatively and 16 (46%) patients were subjected to surgery.
Results:
In the group of conservative therapy there was an average deterioration by 4.1° (11%). In the group of simple fusion there was the surgical correction of scoliosis by 9.8° (22.1%) was achieved, in the group of posterior instrumental fusion being 25.61° (38%), 32° (52%) in the group of combined interventions and 19° (35%) in the mixed disorder group.
Conclusion:
Early detection, good timing and selection of adequate therapeutic procedure belong to the basic factors of good therapeutic result. All surgical methods resulted on the average in a correction of scoliosis curve and it long-term persistence. The best results and minimum complications were obtained with hemivertebrectomy supplemented by posterior stabilization and 360° bone fusion.
Key words:
inborn scoliosis, operation, combined interventions, diastematomyelia
Zdroje
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Štítky
Neonatology Paediatrics General practitioner for children and adolescentsČlánok vyšiel v časopise
Czech-Slovak Pediatrics
2008 Číslo 6
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