Mineiro Jorge, Yazici Muharrem
Department of Orthopaedics and Traumatology, Orthopaedic Spine Unit, Hospital CUF Descobertas, Lisbon, Portugal.
Paediatric Spine Unit, Hospital Dª Estefania, Lisbon, Portugal.
J Child Orthop. 2020 Feb 1;14(1):30-40. doi: 10.1302/1863-2548.14.190167.
Cerebral palsy (CP) is a disorder arising from a non-progressive lesion in the developing immature brain with an encephalopathy, that results in various levels of motor and sensory dysfunction. Motor disability of these children can be assessed by the Gross Motor Function Classification System in five levels, and depending on their motor functional capability, the most severely affected children fall into levels IV and V. Children in groups IV and V present a full spectrum of musculoskeletal deformities, among which, scoliosis is the most frequently found spinal deformity that most often requires surgical treatment. However, these are procedures that are usually technically demanding, requiring experienced surgical teams and a multidisciplinary approach.
In order to overcome some of the technical pitfalls that may complicate these complex surgical procedures, the authors have gathered together different tips and tricks that may help surgeons performing surgical correction of spinal deformities in CP children.
Although for these children surgery is a major undertaking, with the multidisciplinary approach and advances of technology, anaesthesia and optimization of pre- and postoperative care, complications are manageable in most cases, improving not only the outcome of surgery but also the patient's quality of life and satisfaction of parents and caretakers.
脑性瘫痪（CP）是一种由发育中的未成熟大脑的非进行性病变伴脑病引起的疾病，会导致不同程度的运动和感觉功能障碍。这些儿童的运动残疾可通过粗大运动功能分类系统分为五个级别，根据其运动功能能力，受影响最严重的儿童属于IV级和V级。IV级和V级儿童存在一系列肌肉骨骼畸形，其中脊柱侧弯是最常见的脊柱畸形，通常最需要手术治疗。然而，这些手术通常技术要求很高，需要经验丰富的手术团队和多学科方法。
为了克服可能使这些复杂手术程序复杂化的一些技术难题，作者收集了不同的技巧和窍门，可能有助于外科医生对CP儿童进行脊柱畸形的手术矫正。
尽管对这些儿童来说手术是一项重大任务，但通过多学科方法以及技术、麻醉的进步和术前术后护理的优化，大多数情况下并发症是可控的，不仅改善了手术结果，还提高了患者的生活质量以及家长和护理人员的满意度。
