scholarly journals TACTIC IN SURGICAL TREATMENT OF THORACIC IDIOPATHIC SCOLIOSIS IN CHILDREN

2010 ◽  
Vol 16 (2) ◽  
pp. 82-85
Author(s):  
S. V. Vissarionov ◽  
A. P. Drozdetsky

The results of surgical treatment of 263 patients with thoracic scoliosis from 13 to 18 years old with deformity 50-152° (Cobb) are presented. It was used three tactical variants with dorsal instrumentation Cotrel-Dubousset (CDI). Operation correction in idiopathic thoracic scoliosis varies within in limits from 46,2 to 95%. Lost of correction in 10 years follow up period was 5,10-10,15%. Authors concluded that tactic of surgical treatment of idiopathic thoracic scoliosis should be individual and depends on patient's age, growth potential, and degree of deformation and mobility of the curve.

2006 ◽  
pp. 025-032
Author(s):  
Mikhail Vitalyevich Mikhailovsky ◽  
Vyacheslav Viktorovich Novikov ◽  
Aleksandr Sergeyevich Vasyura ◽  
Elena Vladimirovna Gubina ◽  
Albert Leonidovich Khanaev ◽  
...  

Objective. To analyze results of surgical treatment of patients with thoracic idiopathic scoliosis. Material and Methods. Fifty-two patients with Lenke type 1 idiopathic scoliosis were operated on. Follow-up periods ranged from 2 weeks to 8 years (mean 1.8 years). Surgical treatment included four types of operation: spine deformity correction with CD instrumentation; supramalleolar-andskull traction and CDI correction; discectomy and interbody fusion with bone autograft and CDI correction; supramalleolar- and-skull traction, discectomy and interbody fusion with bone autograft, and CDI correction. Patients were interrogated with pre- and postoperative SRS-24 questionnaires and examined with Computer Optical Topograph (COMOT). Results. Scoliosis was corrected from a mean of 67.7° to 26.6°, with a mean deformity value being 30.3° at the last follow- up. Thus, postoperative progression of the thoracic curve with a mean follow-up 1.8 years was 3.7° (9 % from the achieved correction). Anterior fusion provided a threefold decrease in postoperative progression. Sagittal shape of the thoracic and lumbar spine remained within norm limits. The location of the lowest instrumented vertebra (LIV) relative to a neutral vertebra, lower stable vertebra and neutralized disc did not reliably influence on the postoperative course. Postoperative deformity progression was associated only with increase in LIV tilt. SRS-24 data showed a high rate of patients’ satisfaction with the obtained effect of treatment, the rate growing with the extension of follow-up terms. Severe complications were not observed. Conclusion. Modern 3rd generation segmental instrumentation allows to obtain stable and high results of treatment for single curve thoracic idiopathic deformities, while all regularities of postoperative course are not fully understood yet.


2014 ◽  
Vol 2 (2) ◽  
pp. 3-8 ◽  
Author(s):  
Sergei Valentinovich Vissarionov ◽  
Dmitriy Nikolaevich Kokushin ◽  
Sergei Mikhailovich Belyanchikov ◽  
Vladislav Valerievich Murashko ◽  
Kirill Aleksandrovich Kartavenko ◽  
...  

The purpose of the study. To assess the results of surgical treatment in children with idiopathic scoliosis of thoracic localization. Material and methods. We operated 56 patients aged from 13 to 18 years old with a level of deformity 40-136° according to Cobb. Surgical correction of the deformity was performed with three tactical options using Cotrel-Dubousset dorsal instrumentation. Results. In idiopathic thoracic scoliosis the operating correction ranged from 48 to 100 %. Loss of correction in the follow-up period from 1 year to 3.5 years was 0-7 %. Conclusion. Surgical treatment of idiopathic thoracic scoliosis should be individualized. Application of multisupporting transpedicular metal constructions allows to increase the degree of deformity correction, to perform true derotation of vertebral bodies on top of curvature and to save the result achieved in the postoperative period.


2019 ◽  
Vol 86 (5) ◽  
Author(s):  
Barón Zárate-Kalfópulos ◽  
Héctor R. Martínez-Ríos ◽  
Francisco López-Meléndez ◽  
Carla L. García-Ramos ◽  
Luis M. Rosales-Olivarez ◽  
...  

2018 ◽  
Vol 100-B (8) ◽  
pp. 1080-1086 ◽  
Author(s):  
A. Charalampidis ◽  
A. Möller ◽  
M-L. Wretling ◽  
T. Brismar ◽  
P. Gerdhem

Aims There is little information about the optimum number of implants to be used in the surgical treatment of idiopathic scoliosis. Retrospective analysis of prospectively collected data from the Swedish spine register was undertaken to discover whether more implants per operated vertebra (implant density) leads to a better outcome in the treatment of idiopathic scoliosis. The hypothesis was that implant density is not associated with patient-reported outcomes, the correction of the curve or the rate of reoperation. Patients and Methods A total of 328 patients with idiopathic scoliosis, aged between ten and 20 years at the time of surgery, were identified in the Swedish spine register (Swespine) and had patient reported outcomes including the Scoliosis Research Society 22r instrument (SRS-22r) score, EuroQol 5 dimensions quality of life, 3 level (EQ-5D-3L) score and a Viual Analogue Score (VAS) for back pain, at a mean follow-up of 3.1 years and reoperation data at a mean follow-up of 5.5 years. Implant data and the correction of the curve were assessed from radiographs, preoperatively and a mean of 1.9 years postoperatively. The patients were divided into tertiles based on implant density. Data were analyzed with analysis of variance, logistic regression or log-rank test. Some analyses were adjusted for gender, age at the time of surgery, the flexibility of the major curve and follow-up. Results The mean number of implants per operated vertebra in the low, medium and high-density groups were 1.36 (1.00 to 1.54), 1.65 (1.55 to 1.75) and 1.91 (1.77 to 2.00), respectively. There were no statistically significant differences in the correction of the curve, the SRS-22r total score, EQ-5D-3L index or number of reoperations between the groups (all p > 0.34). In the SRS-22r domains, self-image was marginally higher in the medium implant density group (p = 0.029) and satisfaction marginally higher in the high implant density group (p = 0.034). Conclusion These findings suggest that there is no clear advantage in using a high number of implants per operated vertebra in the surgical treatment of patients with idiopathic scoliosis. Cite this article: Bone Joint J 2018;100-B:1080–6.


1994 ◽  
Vol 4 (1) ◽  
pp. 53-58
Author(s):  
F. Specchiulli ◽  
L. Scialpi ◽  
G. Solafino ◽  
L. Battelli ◽  
L. Nitti

In CHD (Congenital Hip Dislocation), the elements which determine the degree and quality of acetabular growth are not clear. This has caused a great deal of controversy on the capability of development of the cotyloid cavity, hence on the indications to reconstructive surgical treatment. In order to study the behavior of che cotyloid cavity, two groups of patients were taken into consideration: normal subjects and subjects with CHD. In normal subjects the median value of the Hingelreiner angle was 19°–4'± 1° (normal limit), at 1 year old. The acetabular index decreases rapidly until becoming stable at adult values at the age of 8-10 years of age. The distinctive characteristics of the hip with spontaneous recovery from cotyloid dysplasia could be defined as follows: a) the higher critical value on average is reached after 24 months of treatment; b) once the borderline is reached, the dislocated hip evolves in the same way as the healthy hip; c) the earlier treatment is started, the sooner correction of the H angle is obtained; d) the cotyloid cavity continues to develop even after 5 years from reduction. In CHD with terminal residual dysplasia, an initial correction of the H angle is followed by a sudden interruption in acetabular development, which remains inadequate and will never reach normal values. These data allow not only the definition of the acetabular growth potential, but also the establishment of more precise indications for reconstructive surgical treatment.


2019 ◽  
Vol 101 (16) ◽  
pp. 1460-1466 ◽  
Author(s):  
Linda Helenius ◽  
Elias Diarbakerli ◽  
Anna Grauers ◽  
Markus Lastikka ◽  
Hanna Oksanen ◽  
...  

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Sébastien Pesenti ◽  
Antoine Chalopin ◽  
Emilie Peltier ◽  
Elie Choufani ◽  
Matthieu Ollivier ◽  
...  

Hypokyphosis is currently observed in thoracic idiopathic scoliosis. The use of sublaminar bands allows a good restoration of sagittal balance of the spine. The aim of the study was to provide a middle-term radiographic analysis of patients with adolescent idiopathic scoliosis with preoperative hypokyphosis treated by posterior arthrodesis with sublaminar bands. This retrospective study included 34 patients with Lenke 1 scoliosis associated with hypokyphosis (TK < 20°). A radiographic evaluation was performed with a 2-year follow-up. Cobb angle, cervical lordosis, thoracic kyphosis, lumbar lordosis, and pelvic parameters were measured preoperatively, postoperatively, and at 6-month and 2-year follow-up. The mean preoperative thoracic kyphosis was 10.5° versus 24.1° postoperatively (p<0.001), representing a mean gain of 13°. Cobb angle ranged from 59.3° to 17.9° postoperatively (mean correction 69%,p<0.001). Cobb angle increased between the immediate postoperative measurement and the 6-month follow-up (17.9 versus 19.9,p=0.03). Cervical curvature changed from a 5.6° kyphosis to a 3.5° lordosis (p=0.001). Concerning lumbar lordosis, preoperative measurement was 39.7° versus 41.3° postoperatively (p=0.27). At 6-month follow-up, lumbar lordosis significantly increased to 43.6° (p=0.03). All parameters were stable at final follow-up. Correction performed by sublaminar bands is efficient for both fontal and sagittal planes. Moreover, the restoration of normal thoracic kyphosis is followed by an adaptation of the adjacent curvatures with improved cervical lordosis and lumbar lordosis.


2022 ◽  
Vol 16 (1) ◽  
Author(s):  
Jeb. McAviney ◽  
Benjamin T. Brown

Abstract Background The recommended treatment for mild to moderate infantile idiopathic scoliosis curves involves serial casting. There are concerns, however, regarding the safety of repeated casting in very young children owing to the requirement for anesthetization during the casting process. Very little research has been conducted on the influence of bracing as an initial treatment for scoliosis in this age group. This report details the successful treatment of a large thoracic curve using a thoracolumbosacral orthosis in an infant diagnosed with infantile idiopathic scoliosis. Case presentation The Dutch-Australian patient presented at 11 weeks of age with a 44° thoracic scoliosis and a rib vertebral angle difference of 14°. The history and physical examination failed to reveal a cause of the curvature, and a diagnosis of infantile idiopathic scoliosis was made. The patient was prescribed a thoracolumbosacral orthosis (ScoliBrace) to be worn on a part-time basis for a period of 8 months. At the end of the bracing program, the patient’s curve had been reduced to 7° and a rib–vertebral angle difference of 0°. A final follow-up of the patient at 2 years after the cessation of treatment revealed no evidence of scoliosis. The parents were compliant with the bracing protocol and reported that the treatment was tolerated by the infant. Conclusion The use of an orthosis as a standalone treatment in this patient resulted in significant reduction in a large thoracic scoliosis. Based on the results witnessed in this patient, further investigation into bracing as an alternative to casting is warranted.


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