Прогнозирование Течения Врожденных Деформаций Позвоночника У Детей

Казарян, И В; Vissarionov, Sergey

doi:10.14531/ss2014.3.38-44

Cited by 4 publications

(2 citation statements)

References 11 publications

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“…Окрім того, прогресуючі анатомо-функціональні порушення обумовлюють наростання патологічних змін органів грудної клітки, погіршення загального стану хворого. На цій підставі сколіоз розглядають не лише як захворювання хребта, а як сколіотичну хворобу організму [19][20][21].…”

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Birth Defects of Human Spinal Column

Besplitnik¹

2019

CAOS

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Various anomalies of spinal column development have common clinical manifestations. However, each defect has certain features that affect the nature of the deformity, the rate of its progression, the function of the spinal cord and the possibility of developing neurological disorders. An increase in deformation in the anomaly zone can lead to segmental instability at this level, which further cause disturbance of the biomechanics of the spine in general. The cervical section is the most mobile section of the spine, which is provided by the structure of the Atlantic-axial complex and functional mobility of the subaxial section. The detected anomaly should be evaluated in terms of the likelihood of developing instability. Mechanical instability is manifested by the displacement of vertebrae beyond the physiological range of movements. Neurological instability is mostly manifested in the subaxial section of the spine, as the reserve space of the spinal canal is extremely small. Congenital abnormalities of the thoracic spine that lead to deformity are the most common defects against the ground of impaired formation of vertebral bodies. Children with congenital kyphosis are motionless, and dyspnea occurs while walking fast or jogging. Surgical treatment of kyphotic deformities of the thoracic and lumbar spine is one of the most difficult problems in modern orthopedics, the relevance of which is stipulated by a relatively high frequency of unsatisfactory results of treatment. Lumbarisation is a congenital malformation of the spine, accompanied by the formation of an additional lumbar vertebra, which is formed from the superior sacral vertebra that has not fused into a single bone with the other sacral vertebrae. The frequency of occurrence is unknown, because lumbarisation in some cases is asymptomatic and undiagnosed. Depending on the nature of anatomical changes and the peculiarities of the influence on the dynamic and static functions of the spine, unilateral and bilateral lumbarisation are distinguished. Both unilateral and bilateral forms can be bone, cartilage and joint. The development of pain is characteristic only of the joint form of lumbarisation. Caudal regression syndrome is a rare severe congenital malformation of the distal spine and spinal cord. Clinically the disease is accompanied by hypoplasia of the lower half of the trunk and extremities due to a gross defect in the development of the caudal spine and spinal cord. Depending on the level and severity of the lesion of the latter there is a different stage of neurological deficit. In most observations, caudal regression syndrome is combined with defects in other organs and systems. Depending on the level of damage to the spine, coccyx, sacral, lumbar and even lower thoracic vertebrae may be absent, which determines the variant of the defect. An extremely severe form of caudal regression is called sirenomelia, or "mermaid syndrome". A sign of this anomaly is the fusion of the lower extremities. The fusion can be osseous or within soft tissue. In most cases with sirenomelia renal agenesis is observed, the colon ends blindly, the external and internal genitalia are absent, a single umbilical artery and anus atresia are detected. The quality of life prognosis for patients with caudal regression syndrome depends on the severity of spinal and spinal cord defects, the severity of neurological disorders, and urological complications. Children need constant medical rehabilitation.

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Birth Defects of Human Spinal Column

Besplitnik¹

2019

CAOS

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“…Ча-стота верификации различных осложнений в спи-нальной хирургии остается достаточно высокой и, по данным разных авторов, находится на уровне 9-33 % [9, 19,23,24]. У взрослого населения ком-пликации после хирургических вмешательств на позвоночнике верифицируются чаще, чем у детей [7,25,26]. Процент осложнений выше у курящих пациентов, при констатации высокого индекса массы тела, в случаях сахарного диабета и при ряде других отягчающих факторов [27][28][29][30][31].…”

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Rate and structure of complications in spine surgery

Fadeev

Михайлович²,

Haydarov

et al. 2017

Pediatr Traum Orthop Reconstr Surg

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The risk of intraoperative and postoperative complications after spinal surgery still remains in the hospital-acquired conditions of any hospital. The methods for performing spinal surgery in children and adults are developing and constantly improving. A significant number of constructions for performing spinal surgery are created by leading manufacturers. The frequency of local and systemic surgical complications has not decreased. Knowing the rate and structure spinal surgery complications can expand the ability to predict and prevent them, which is important for medical science and practice. The presented review of literature addressed the current state of knowledge on spinal surgery complications.

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Assessment of the efficacy of treatment for children with congenital scoliosis with unsegmented bar and rib synostosis

Vissarionov

Asadulaev²,

Orlova³

et al. 2022

Pediatr Traum Orthop Reconstr Surg

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BACKGROUND: Treatment of children with congenital deformity with unsegmented rod and rib synostosis is an important and topical problem to date. Topical publications present the results of surgical correction efficacy and analysis of treatment complications. The extremely important aspect of treatment efficacy assessment regarding changes in the function of external respiration is still topical. AIM: This study aimed to analyze the treatment results of children with congenital scoliosis and unilateral segmentation disorder of the lateral surfaces of the vertebral bodies and rib synostosis. MATERIALS AND METHODS: This is a retrospective monocenter cohort study of the treatment outcomes of 30 patients aged 114 years. In the preoperative period, external respiration was evaluated by pulse oscillometry, multi-slice computed tomography, digital X-ray imaging of the craniopelvis in two projections. All patients underwent expanding thoracoplasty with osteotomy of the rib synostosis and fixation with a rib-costal or rib-vertebral distractor. Control studies were performed every 6 months after the surgical intervention. The average follow-up period was 2 years. Nonparametric analysis was applied to estimate the obtained data. RESULTS: The median (Me) age at the start of treatment was 6 years (interquartile range, 4.25; IQR hereafter). The Me scoliosis before treatment was 74 (IQR, 22.75). The Me scoliosis correction after the first stage of treatment was 16 (IQR, 11) and the second correction achieved 6 (IQR, 13). The Me kyphosis was 15 (IQR, 32), the first intervention improved kyphosis by 4 (IQR, 16), and the second by 6 (IQR, 11). Complications were represented by the destabilization of the metal construct in six cases, and trophic disorders of soft tissues were noted in four. The assessment of external respiratory function using IOM demonstrates reliable improvement of resistive component, reactive component, and frequency dependence of the resistive component (p 0,01). CONCLUSIONS: The assessment of the external respiratory function in young children and analysis of reference values may allow their use as absolute indications for surgical treatment in children with congenital scoliosis with unsegmented bar and rib synostosis.

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Прогнозирование Течения Врожденных Деформаций Позвоночника У Детей

Abstract: Prediction of the course of congenital spinal deformities in childrenThe review of literature presents the results of studies on methods for predicting the course of congenital spinal deformities in children.

Cited by 4 publications

References 11 publications

Birth Defects of Human Spinal Column

Birth Defects of Human Spinal Column

Rate and structure of complications in spine surgery

Assessment of the efficacy of treatment for children with congenital scoliosis with unsegmented bar and rib synostosis

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