SURGICAL CORRECTION OF KYPHOSIS ASSOCIATED WITH SCHEUERMANN’S DISEASE

Objective. To analyze the results of two-stage surgical treatment of progressive kyphosis associated with Scheuermann’s disease performed in the Spine Surgery Department for Children and Adolescents from 1996 till 2004. Material and Methods. Fourteen patients were surgically treated. Surgical intervention included segmental vertebrectomy, interbody fusion, and kyphosis correction with Cotrel – Dubousset Instrumentation (CDI). Results. Kyphosis was reduced from 78.1° to 43.4°; the loss of correction during the follow-up period (minimum 2 years) was 4.4°. Sagittal contour of the lower thoracic and lumbar spine was also normalized. Conclusion. Two-stage surgical intervention permits to achieve significant cosmetic and pain-reducing effect in patients with major kyphosis associated with Scheuermann’s disease.

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Scheuermann’s disease surgery. Major problems: non-systematic literature review (part I).

Hirurgiâ pozvonočnika ◽

10.14531/ss2021.3.6-18 ◽

2021 ◽

Vol 18 (3) ◽

pp. 6-18

Author(s):

M. V. Mikhaylovskiy ◽

V. L. Lukinov

Keyword(s):

Quality Of Life ◽

Blood Loss ◽

Intraoperative Blood Loss ◽

Two Stage ◽

Scheuermann’S Disease ◽

Scheuermann's Disease ◽

One Stage ◽

Surgery Duration

Objective. To perform multivariate comparison of two surgical strategies in the treatment of patients with severe Scheuermann’s disease.Material and Methods. The search of sources (in Scopus and Web of Science databases) revealed 56 publications containing the required information. The literature data were analyzed in four directions: the results of one- and two-stage interventions are compared in terms of the magnitude of achieved correction and its preservation, the complication rate, the surgery duration and the volume of intraoperative blood loss, and the quality of life of patients in the postoperative period.Results. The magnitude of the achieved correction of kyphotic deformity and postoperative loss of correction in patients after one- and two-stage operations are almost identical. Implant-associated complications are more often observed after one-stage operations, and purulent, neurological and other complications – after two-stage operations. Surgery duration and intraoperative blood loss volume are greater in two-stage operations. The quality of life assessed by various questionnaires is significantly improved, regardless of the type of surgery.Conclusion. Two-stage surgical correction of Scheuermann’s kyphosis has no noticeable advantages over one-stage surgery, however, new studies with long (more than 15–18 years) postoperative follow-up are needed.

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Progressive Scoliosis and Syringomyelia - Questions of Surgical Approach

Folia Medica ◽

10.1515/folmed-2017-0099 ◽

2018 ◽

Vol 60 (2) ◽

pp. 261-269 ◽

Cited By ~ 1

Author(s):

Mikhail Mikhaylovskiy ◽

Vyacheslav Stupak ◽

Vadim Belozerov ◽

Nikolay Fomichev ◽

Anatoliy Lutsik ◽

...

Keyword(s):

Surgical Intervention ◽

Surgical Correction ◽

Neurological Deficits ◽

Spinal Deformities ◽

Loss Of Correction ◽

Scoliotic Deformity ◽

Scoliosis Correction ◽

The Moment ◽

Comparison Of The Results

Abstract Background: The rate of scoliosis in syringomyelia patients ranges from 25 to 74.4%. In turn, syringomyelia occurs in 1.2% to 9.7% of scoliosis patients. Aim: To evaluate outcomes of surgical correction of the scoliotic deformity in syringomyelia patients. Materials and methods: Between 1996 and 2015, 3120 patients with scoliosis of various etiologies were treated at the Clinic for Child and Adolescent Vertebrology of the Novosibirsk Research Institute of Traumatology and Orthopedics. We conducted a retrospective analysis of syringomyelia-associated scoliosis cases that required surgical correction. Results: Syringomyelia was found in 33 patients (1.05%) out of 3120 patients with spinal deformities of various etiologies; in 21 patients (0.9%) with idiopathic scoliosis of 2334 patients. In identifying the neurological deficit, the recommended first step is to perform neurosurgery. Nineteen patients were operated using the CDI, 4 patients underwent correction VEPTR, in 1 case instrumentation could not be established, 9 patients are undergoing treatment in the department of neurosurgery at the moment. Worsening of neurological deficits was not observed in any patient. Conclusion: A comparison of the results of syringomyelia-associated scoliosis correction with the data of other authors was done. The choice of surgery tactics is strictly individual and depends on the size of the cavity. The result of surgical intervention is generally positive and the loss of correction by the end of follow-up is negligible.

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Radiological Signs of Scheuermann's Disease and Low Back Pain: Lumbar MR Classification and Six-Year Low Back Pain Follow-Up in 188 Hospital Staff Members

The Spine Journal ◽

10.1016/j.spinee.2014.08.310 ◽

2014 ◽

Vol 14 (11) ◽

pp. S125-S126

Author(s):

Zhongqiang Chen

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Hospital Staff ◽

Low Back ◽

Scheuermann’S Disease ◽

Scheuermann's Disease ◽

Staff Members

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Surgical treatment of kyphosis in children with scheuermann’s diseaseusing 3D-CT navigation

Pediatric Traumatology Orthopaedics and Reconstructive Surgery ◽

10.17816/ptors315-14 ◽

2015 ◽

Vol 3 (1) ◽

pp. 5-14

Author(s):

Sergei Valentinovich Vissarionov ◽

Dmitriy Nikolaevich Kokushin ◽

Sergei Mikhailovich Belyanchikov ◽

Vladislav Valerievich Murashko

Keyword(s):

Surgical Treatment ◽

Deformity Correction ◽

Pedicle Screws ◽

3D Ct ◽

Scheuermann’S Disease ◽

Scheuermann's Disease ◽

Transpedicular Fixation ◽

Long Term Follow Up

The purpose of the study is to describe features of the surgical technique for correction of kyphotic deformity of the spine and to analyze the results of surgical treatment of juvenile kyphosis in children with the use of 3D-CT navigation. Materials and methods. We observed 11 patientsaged 14-17 years old (2 girls and 9 boys) with kyphoticdeformity of the spine, developed on the backgroundof Scheuermann’s disease. The deformity amount aver-aged 73,9° (60 to 90°). Surgery was performed fromthe combined access, carring out discapophysectomyand corporodesis on top of kyphosis and fixing mul-tibasic corrective metal construction. For the insertionof pedicle screws we used 3D-CT navigation. The results. After surgery kyphosis value decreasedto 32,6° (20 to 45°), the deformity correction averaged41,3° (30 to 50°). Hybrid systems were placed in 5 pa-tients, total transpedicular fixation - in 6 children.Number of fixed vertebrae with hybrid metal construc-tions averaged 14 (13 to 15), in patients with total pediclefixation - 13 (12 to 14). In all cases we observed the correct position of pedicle support elements. Postopera- tive follow-up period was from 1 year and 5 months to5 years and 4 months, on average - 3 years 5 months. The loss of the result achieved in the long-term follow- up period was observed in patients with hybrid metal constructions and averaged 7,2° (4 to 9°). Conclusion. The use of pedicle screws for thecorrection of juvenile kyphosis in children allows forthe effective correction of the deformity, restoring thephysiological profiles of the spine, eliminating post-operative progression of curvature, and reducing thelength of metal fixation and save the result achievedin the long-term follow-up. The use of active optical3D-CT navigation allows carring out a correct inser-tion of pedicle screws in the vertebral bodies in chil-dren with juvenile kyphosis. Keywords: Scheuermann’s disease, juvenile ky-phosis, transpedicular fixation, navigation, children,surgical treatment.

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Scheuermann’s disease surgery. Major problems: non-systematic literature review (part II)

Hirurgiâ pozvonočnika ◽

10.14531/ss2021.4.28-40 ◽

2021 ◽

Vol 18 (4) ◽

pp. 28-40

Author(s):

Mikhail Vitalyevich Mikhaylovskiy

Keyword(s):

Risk Factors ◽

Web Of Science ◽

Scheuermann’S Disease ◽

Scheuermann's Disease ◽

Literary Sources ◽

Potential Risk Factors ◽

Proximal Junctional Failure ◽

Distal Junctional Kyphosis ◽

Junctional Kyphosis

Objective. To analyze literature data on the frequency of junctional kyphosis in surgery for Scheuermann’s disease, its relationship withspinopelvic parameters, risk factors and prevention of its development.Material and Methods. A search for sources in Scopus and Web of Science databases revealed 62 articles published from 1975 to 2021 and containing the required information. Of these, 56 publications meet the inclusion criteria.Results. The selected 56 articles contain data on 2,110 patients. In total, 247 (11.8 %) cases of proximal junctional kyphosis were diagnosed, including 6 (0.3 %) cases of proximal junctional failure. The total number of distal junctional kyphosis cases was 124 (5.9 %). Forty-five reoperations were performed. Many potential risk factors have been identified in publications, but there is no consensus on any of them.As a result, there is no a well-founded common position on the prevention of junctional kyphosis development. Spinopelvic parameters in Scheuermann’s disease are significantly less than those in the general population and do not tend to change after surgical correction of kyphosis. As for their relationship with the risk of development of proximal and distal junctional kyphosis, there is no consensus to date.Conclusion. This review is the largest in terms of coverage of literary sources on the problem of the development of junctional kyphosis in surgery for Scheuermann’s disease. The causes for the development of this complication remain unknown, hence there is the lack of generally accepted methods of prevention. New studies with long postoperative follow-up are needed.

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Possibilities of Transpedicular Osteosynthesis in Treatment of Thoracic and Lumbar Spine Injuries

N.N. Priorov Journal of Traumatology and Orthopedics ◽

10.17816/vto200411468-74 ◽

2004 ◽

Vol 11 (4) ◽

pp. 68-74

Author(s):

A A Afaunov ◽

V D Usikov ◽

A I Afaunov ◽

A A Afaunov ◽

V D Usikov ◽

...

Keyword(s):

Lumbar Spine ◽

Fixation Device ◽

Loss Of Correction ◽

Spine Injuries ◽

Thoracic And Lumbar Spine ◽

Different Types ◽

Local Kyphosis ◽

External Fixation Device ◽

Vertical Size

Results of surgical treatment of 84 patients with thoracic and lumbar spine injuries using transpedicular osteosynthesis are presented. The patients were operated on within the terms from 2 days to 3.5 years after trauma. Different types of surgical reposition were used depending on the terms after injury and value of deformity. In 51 patients anterior corporodesis was performed. Average correction of local kyphosis was from 7.4° to 17.7° in different groups of patients. Vertical size of inured segments was restored up to 63.8-92%. Suggested method of intraoperative spine reposition enabled to increase the correction volume 1.7-2 times in late terms after injury. In severe deformities preliminary stage, i.e. transpedicular osteosynthesis using external fixation device with gradual correction over 35° was used. Complications - fracture of longitudinal rod (3 cases), partial destabilization of spine column in osteoporosis (2 cases), as well as loss of correction by 2-3° (9 cases) and 6-15° (3 cases) did not influence the outcomes significantly. In 48 patients the follow-up period was over 1 year. In 44 patients good results were achieved and satisfactory result was noted in 4 patients.

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Outcome analysis of surgically managed unstable burst fracture

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20160340 ◽

2015 ◽

Vol 1 (1) ◽

pp. 3

Author(s):

Ganesan G. Ram ◽

P. V. Vijayaraghavan ◽

Kannan Karthik Kailash

Keyword(s):

Lumbar Spine ◽

Bone Graft ◽

Neurological Deficit ◽

Unstable Fracture ◽

Anterior Decompression ◽

Loss Of Correction ◽

Burst Fractures ◽

Cord Injury ◽

Thoracic And Lumbar Spine

Background:Burst fractures are common injuries of dorsolumbar spine. In indicated cases, surgery is the treatment of choice. Significant controversy exists regarding surgical intervention for these fractures. Posterior decompression, anterior decompression and instrumentation, and combined anterior decompression and posterior instrumentation have been recommended in various studies. Here we are going to evaluate unstable burst fractures of thoracic and lumbar spine treated by isolated anterior decompression and instrumented fusion with TSM-Bone graft composite.Methods: Prospective study of thirty-six cases of unstable fracture of thoracic and lumbar spine treated in Sri Ramachandra Medical centre from January 2011 to January 2014. The inclusion criteria were burst fractures of thoracic or lumbar spine complete or incomplete neurological deficit and burst fractures of thoracic or lumbar spine without neurological deficit but with mechanical instability. The exclusion criteria were pathological fractures, chance fracture, stable burst, wedge compression and osteoporotic compression fractures. The results were analyzed during the follow-up using the Pain – Visual analogue scale, Fusion status and radiographic parameter – K-angle .For pain score were given as 3,2,1 for absent, moderate and severe pain respectively. Regarding fusion status score of 3,2,1 were given when fusion was good, fair and no sign of fusion respectively.Results:Mean pre-operative K-angle was 28o. Average loss of correction at final follow up was 3o.Mean correction of K-angle was 140.Moderate to severe loss of correction of K- angle was observed in 4 patients. Mild to moderate pain in 5 patients treated with analgesics. Average TSM subsidence was 3mm.Conclusions:Bone graft composite provides stable biomechanical support to deficient anterior column in burst fractures and allows early rehabilitation and mobilization. Neural recovery may occur after anterior decompression, stabilization and fusion with TSM-Bone graft composite in dorsolumbar burst fractures with incomplete cord injury.

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Abdominal Lymphangioma and Hemangioma in a Newborn

Case Reports in Pediatrics ◽

10.1155/2019/6879168 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4

Author(s):

Charikleia D. Demiri ◽

Christos Kaselas ◽

Dimitrios Godosis ◽

Andreas Neofytou ◽

Ioannis Spyridakis

Keyword(s):

Surgical Intervention ◽

Rare Condition ◽

Surgical Excision ◽

Diagnostic Approach ◽

Cystic Tumor ◽

Therapeutic Algorithm ◽

Preoperative Diagnostic ◽

Operative Findings ◽

Surgery Department

Abdominal hemangiolymphangioma (HLA) in neonates is a rare condition that demands surgical intervention after a complete preoperative diagnostic approach. The differential diagnosis and the establishment of a therapeutic algorithm is a challenge, both for the neonatologists and the pediatric surgeons, because there is no consensus in the management of HLAs in infancy according to the literature. We report a rare case of abdominal HLA in a female newborn that was admitted to our pediatric surgery department with a prenatal diagnosis of an abdominal cystic tumor. After a thorough preoperative diagnostic approach, the neonate underwent an explorative laparotomy and lesion excision with simultaneous splenectomy due to the operative findings. The neonate had an uncomplicated postoperative period and is free of recurrence a year after. Only the pathology examination can reveal the HLA diagnosis. When a total surgical excision is evitable, a close follow-up follows an uncomplicated postoperative hospitalization.

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Functional and radiological analysis of posterior lumbar interbody fusion in spondylolisthesis

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20160342 ◽

2015 ◽

Vol 1 (1) ◽

pp. 11

Author(s):

Ramanujam Muthu Manickam ◽

Ganesan G. Ram ◽

S. Sundar ◽

A. Prakash

Keyword(s):

Pedicle Screw ◽

Interbody Fusion ◽

Surgical Intervention ◽

Degenerative Spondylolisthesis ◽

Posterior Lumbar Interbody Fusion ◽

Low Grade ◽

Lumbar Interbody Fusion ◽

Isthmic Spondylolisthesis ◽

The Mean

Background:Spondylolisthesis is present in 5% of the adult population with clinical evidence of low back pain. These patients are treated initially by conservative measures, failing of which surgical intervention is mandatory. Majority of patients with varying degree of slip and disability ultimately require surgical intervention. In this study we are trying to analyse the functional outcome following posterior lumbar interbody fusion in spondylolisthesis.Methods: Posterior lumbar interbody fusion using pedicle screw and rods with cage was performed on 25 patients. 6 months follow-up was completed in 25 patients who were then reviewed at regular intervals. Out of the 25 patients, 17(68%) were females and 8(32%) were males. The mean age of the patients was 40.64 years. Out of 25 patients, 14 patients had listhesis at L4 – L5 level and another 11 at L5 – S1 level. 21(84%) were Isthmic variant and 4 (16%) were Degenerative spondylolisthesis.Results:The mean follow up period in this study of 25 patients is 19 months. Out of 25 patients, there was mean improvement of 18.96 in the Oswestry scoring index. The Visual analogue scale score showed a mean improvement of 6.48. Radiologically, the percentage of slip was decreased by a mean of 8.40%. One patient had a cage extrusion with no neurological deficit.Conclusions:The pedicle screw with rod and cage system is easy to use and provides the anatomic restoration of the isthmus in isthmic spondylolisthesis or restoring the stability after laminectomy/discectomy in degenerative spondylolisthesis. From our study, we strongly believe that this technique is very useful in low grade degenerative and isthmic spondylolisthesis.

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