Surgical Treatment Approaches in Severe Spinal Deformities Associated with Intraspinal Pathologies

BACKGROUND: Congenital malformations of the spine require urgent treatment, despite the popularity of this problem. The choice of the term and method of surgical treatment of congenital spinal deformities with vertebral malformations does not have diametrically opposed views in the domestic and foreign literature, but the scientific discussion continues regarding the use of orthotics. Currently, several designs of orthoses on the trunk are known worldwide, which can be used not only for idiopathic but also for congenital scoliosis. А unified view of the use of this type of complex treatment is necessary, but there are opposite opinions in the scientific literature. AIM: This study aimed to analyze publications that present the use of torso orthoses in the treatment of congenital malformations of the spine. MATERIALS AND METHODS: We searched for data in the open electronic databases of PubMed and e-LIBRARY using the following keywords and phrases: congenital deformity of the spine, congenital scoliosis, orthosis, and effectiveness of orthosis. The search covered 30 years of literature. RESULTS: Several authors have reported a significant correction of the congenital curves using orthotics, but this issue has not been sufficiently studied and is still at the research stage. Some specialists consider the formation or progression after the operation of compensatory counter-curve above or below the established metal structure, which can be corrected not only by repeated surgery, but also by using orthoses. CONCLUSIONS: There is a clear trend toward complex treatment of children with isolated congenital malformations of the spine, including a reasonable combination of surgical treatment and orthotics. In Europe and Russia, preference is given to the Rigo system Cheneau brace.

Download Full-text

Posterior Vertebral Column Resection for Severe Spinal Deformities

The Journal of the Korean Orthopaedic Association ◽

10.4055/jkoa.2003.38.1.72 ◽

2003 ◽

Vol 38 (1) ◽

pp. 72 ◽

Cited By ~ 2

Author(s):

Se Il Suk ◽

Jin Hyok Kim ◽

Sang Min Lee ◽

Ewy Ryong Chung ◽

Seong Tae Cho ◽

...

Keyword(s):

Vertebral Column ◽

Spinal Deformities ◽

Vertebral Column Resection ◽

Posterior Vertebral Column Resection ◽

Severe Spinal Deformities

Download Full-text

Preoperative Halo-Gravity Traction for Severe Spinal Deformities at an SRS-GOP Site in West Africa: Protocols, Complications and Results

The Spine Journal ◽

10.1016/j.spinee.2014.08.273 ◽

2014 ◽

Vol 14 (11) ◽

pp. S109

Author(s):

Venu M. Nemani ◽

Benjamin T. Bjerke-Kroll ◽

Mitsuru Yagi ◽

Cristina Sacramento-Dominguez ◽

Harry Akoto ◽

...

Keyword(s):

West Africa ◽

Spinal Deformities ◽

Severe Spinal Deformities

Download Full-text

Surgical Treatment of Spinal Deformities in Young Paraplegic Children with Intraspinal Tumors

Pediatric Neurosurgery ◽

10.1159/000487810 ◽

2018 ◽

Vol 53 (3) ◽

pp. 149-152 ◽

Cited By ~ 2

Author(s):

Heiko M. Lorenz ◽

Lena Braunschweig ◽

Steffen Schiele ◽

Konstantinos Tsaknakis ◽

Marina M. Hecker ◽

...

Keyword(s):

Surgical Treatment ◽

Spinal Deformities

Download Full-text

CONGENITAL THORACOLUMBAR SPINE DEFORMITIES

Neurosurgery ◽

10.1227/01.neu.0000313144.11433.0c ◽

2008 ◽

Vol 63 (suppl_3) ◽

pp. A78-A85 ◽

Cited By ~ 3

Author(s):

Hamidreza Aliabadi ◽

Gerald Grant

Keyword(s):

Surgical Treatment ◽

Spinal Deformity ◽

Congenital Anomalies ◽

Thoracolumbar Spine ◽

Deformity Correction ◽

Spinal Deformities ◽

Spine Deformities ◽

Frequent Reason

ABSTRACT CONGENITAL THORACOLUMBAR SPINAL deformities are a common and frequent reason for referral to spine surgeons. Neurosurgeons also treat many neurological diagnoses which may result in a progressive spinal deformity, such as scoliosis. Here we review a variety of congenital anomalies and address the maldevelopments associated with each, as well as the appropriate evaluation of such patients including nonoperative and operative approaches. Advances in the field of spinal deformity correction now allow us to better treat individuals with these types of deformities. It is important for the practicing neurosurgeon to be knowledgeable of surgical and nonsurgical treatments of patients with congenital thoracolumbar spinal deformities in order to better understand which patients will ultimately progress and necessitate surgical treatment.

Download Full-text

Accuracy of thoracic pedicle screw placement in adolescent patients with severe spinal deformities: a retrospective study comparing drill guide template with free-hand technique

European Spine Journal ◽

10.1007/s00586-017-5410-2 ◽

2017 ◽

Vol 27 (2) ◽

pp. 319-326 ◽

Cited By ~ 8

Author(s):

Yue Pan ◽

G. H. Lü ◽

Lei Kuang ◽

Bing Wang

Keyword(s):

Retrospective Study ◽

Pedicle Screw ◽

Screw Placement ◽

Spinal Deformities ◽

Pedicle Screw Placement ◽

Drill Guide ◽

Thoracic Pedicle Screw ◽

Free Hand Technique ◽

Severe Spinal Deformities ◽

Drill Guide Template

Download Full-text

Revision Versus Primary Patients Undergoing Vertebral Column Resection for Severe Spinal Deformities

Spine Deformity ◽

10.1016/j.jspd.2014.06.001 ◽

2014 ◽

Vol 2 (5) ◽

pp. 350-357 ◽

Cited By ~ 1

Author(s):

Yasushi Oshima ◽

Lawrence G. Lenke ◽

Linda Koester ◽

Katsushi Takeshita

Keyword(s):

Vertebral Column ◽

Spinal Deformities ◽

Vertebral Column Resection ◽

Severe Spinal Deformities

Download Full-text

Pediatric spinal deformities

Neurosurgical FOCUS ◽

10.3171/foc.2003.14.1.4 ◽

2003 ◽

Vol 14 (1) ◽

pp. 1-14 ◽

Cited By ~ 22

Author(s):

Gregory C. Wiggins ◽

Christopher I. Shaffrey ◽

Mark F. Abel ◽

Arnold H. Menezes

Keyword(s):

Surgical Treatment ◽

Developmental Disorders ◽

Thoracoscopic Surgery ◽

Neuromuscular Disorders ◽

Neurological Deficits ◽

Scoliosis Surgery ◽

Spinal Deformities ◽

Spine Instrumentation ◽

Segmental Fixation

Pediatric spinal deformity results from multiple conditions including congenital anomalies, neuromuscular disorders, skeletal dysplasia, and developmental disorders (idiopathic). Pediatric spinal deformities can be progressive and cause pulmonary compromise, neurological deficits, and cardiovascular compromise. The classification and treatment of these disorders have evolved since surgical treatment was popularized when Harrington distraction instrumentation was introduced. The advent of anterior-spine instrumentation systems has challenged the concepts of length of fusion needed to arrest curvature progression. Segmental fixation revolutionized the surgical treatment of these deformities. More recently, pedicle screw–augmented segmental fixation has been introduced and promises once again to shift the standard of surgical therapy. Recent advances in thoracoscopic surgery have made this technique applicable to scoliosis surgery. Not only has surgical treatment progressed but also the classification of different forms of pediatric deformity continues to evolve. Recently, Lenke and associates proposed a new classification for adolescent idiopathic scoliosis. This classification attempts to address some of the shortcomings of the King classification system. In this article the authors review the literature on pediatric spinal deformities and highlight recent insights into classification, treatment, and surgery-related complications.

Download Full-text