Wimmer C, Siam A E, Pfandlsteiner T
Klinik für Wirbelsäulenchirurgie mit Skoliosezentrum Schön-Klinik Vogtareuth, Lehrabteilung der Paracelsus Medizinischen Privatuniversität Salzburg, AO Global Spine Center, Krankenhausstr. 20, 83569, Vogtareuth, Deutschland.
Orthopade. 2015 Nov;44(11):859-68. doi: 10.1007/s00132-015-3166-0.
The indication for the surgical treatment of thoracic, lumbar, combined, and thoracolumbar idiopathic and neuropathic scoliosis is a Cobb angle of more than 50° in the thoracic and more than 45° in the lumbar spine. The success of the operation is highly dependent on the pre-operative indication. Standardized medical imaging and close collaboration with anesthetists and pediatricians are necessary in complex cases.
We developed a screening routine in which pre-operative diagnosis is performed during hospitalization. The concept is individually developed across disciplines. Surgery for childhood scoliosis always presents a particular challenge for anesthetists and surgeons. Close collaboration during surgery is indispensable for guaranteeing success. Risk factors are determined, evaluated and-if necessary-treated before performing surgery. These factors are also strictly monitored and dealt with during surgery.
Regular post-operative check-ups are required to ensure early determination and adequate treatment of complications.
Operative treatment of scoliosis should only be performed in medical centers that allow for close collaboration and diagnostic investigation.
胸段、腰段、联合胸腰段特发性和神经病理性脊柱侧凸的手术治疗指征是胸段Cobb角大于50°,腰段大于45°。手术的成功高度依赖于术前指征。在复杂病例中,标准化医学影像以及与麻醉师和儿科医生的密切合作是必要的。
我们制定了一种筛查程序,在住院期间进行术前诊断。该概念是跨学科单独制定的。儿童脊柱侧凸手术对麻醉师和外科医生来说始终是一项特殊挑战。手术期间的密切合作对于确保成功必不可少。在手术前确定、评估风险因素,并在必要时进行治疗。这些因素在手术期间也会受到严格监测和处理。
需要定期进行术后检查,以确保早期发现并充分治疗并发症。
脊柱侧凸的手术治疗应仅在允许密切合作和诊断检查的医疗中心进行。