SU1561966A1 - Method of treating congenitial scoliosis - Google Patents

Abstract

The invention relates to medicine, namely to orthopedics in the treatment of congenital scoliosis. In order to prevent deformity in congenital scoliosis by disrupting the formation of vertebrae in children before the onset of progression of deformity, the semi-vertebrae is removed from the anterior-lateral approach, the intervertebral discs, the epiphyseal part of the adjacent vertebrae are removed, the semi-vertebrae are pulled together, the vertebrae on the convex side are resected by traction behind the arms, t corpoospondylodesis.

Description

The invention relates to medicine and can be used in pediatric orthopedics in the treatment of congenital scoliosis.

The aim of the invention is to prevent the progression of spinal deformity.

The goal is achieved by the fact that the operation is carried out as early as possible, without waiting for certain periods of deformation progression. Such periods are the moment when the child begins to walk (usually the end of the 1st year) and the period of the first physiological stretching (usually 4-6 years). Considering that most often the diagnosis can be made at the end of the first six months of life, when the child begins to sit down, the question of surgery is raised from this time. At the first stage of the operation from the anterior-lateral access, the semi-vertebral body is resected and its shackle is labeled by inserting into its root the spokes with a puncture on the back. In the second stage of the operation, the marked shackle is removed from the rear access. Such an order of action does not require extensive exposure of the posterior spine, facilitates the search for the back of the semi-vertebral arch and shortens the time of the second stage of the operation.

Improving the stability of the anterior spine is achieved by removing the contact intervertebral discs and epiphyseal plates adjacent to them along with the semi-vertebrae, and after the spine is corrected by the contractor, the intervention on the anterior part of the corpus is supplemented with auto- or allocostum. Installing contractor hooks for the arches of the neutral vertebrae also contributes to greater strength in the area of operation and, moreover, prevents the progression of deformity due to the vertebrae that are directly adjacent to the semi-vertebrae, since these vertebrae often show signs of dysplasia, which is the reason for possible progression of deformity in the postoperative period.

Example. Patient S., born in 1983. From birth, he was treated for bilateral hip dislocation, at the age of 8 months. noticed a spinal deformity. According to the parents, the deformity increased at the beginning of the 2nd year of life. X-ray examination was first conducted in 1 g. 5 months. Hospitalized at the clinic at the age of 1 g. 10 months.

SS

(L

ate

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A radiological examination revealed right-sided scoliosis on the basis of a complete segmented semi-vertebra L on the right, dysplasi Lou. The magnitude of the main arc Tnx „-Li-33 °. Compensatory arc THISC-ТНХц-10 °. Operation No. 462 of 05/31/85.

The child is laid on the left side. Anteroposterior incision along the second intercostal space. The peritoneal peritoneum is stupid anteriorly, the anterior part of the spine is exposed. After ligation of the segmental vessels above the T, HI and Li vertebral bodies, the anterior longitudinal linkage was H-shaped. The body of the semi-vertebrae, the adjacent intervertebral discs and the epiphyseal plates were removed. A Kirschne spoke was inserted into the exposed half-vertebone arch (its base) and placed on the skin of the back. The patient is transferred to the position on the abdomen. Longitudinal section above the spinous processes. Removed tagged half-door handle. Under the arcs of the vertebrae and L „(former L„) the contractor's hooks are installed. A contractor core was installed, after which a compression was made before the arches of the vertebrae Tn ,,, and L were touched. Layer seam posterior wound. The child is again laid on the left side. Autogenous and allografts are laid in the significantly reduced defect between the vertebral bodies, some of them on the front surface of the spine with overlapping of the area of the former semi-vertebrae. Layered

wound suture with Redon-drainage leading to the spine. Sticker.

Smooth postoperative treatment. Primary wound healing. Discharged in plaster

crib. After 2 months made removable hard corset. After 6 months after the first operation, the final stage was performed- 3.12.85 operation: removal of the contractor, posterior-lateral fusion.

3 years after the main

operations and 2.5 after the removal of the contractor, a block was formed between the bodies Tn and L |. The main arc is 10 °, the compensatory was completely corrected. The degree of correction achieved 69% of the original strain.

Claims (1)

Invention Formula A method for treating congenital scoliosis in disorders of the formation of vertebrae in children before the onset of deformity progression by removing the semi-vertebrae from the anterior-lateral access, correcting the deformity by bringing the arches closer by the contractor with the fixation of the spine, in order to prevent the progression of deformity, the intervertebral spine is also resected discs, the epiphyseal part of the adjacent vertebrae, from the back access the half-vertebral arch, and the vertebrae on the convex side pull together traction for the bows of the neutral vertebrae, corporosporodillosis was performed.