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瓦伦丁·A·罗霍津斯基、阿纳托利·F·列维茨基、米科拉·M·多利亚尼斯基、伊琳娜·M·本扎尔 采用头环重力牵引治疗儿童特发性脊柱侧弯严重脊柱畸形

Valentyn A. Rohozynskyi, Anatolii F. Levytskyi, Mykola M. Dolianytskyi, Irina M. Benzar TREATMENT OF SEVERE SPINAL DEFORMATIONS IN CHILDREN WITH IDIOPATHIC SCOLIOSIS USING HALO-GRAVITY TRACTION.

作者信息

Rohozynskyi Valentyn A, Levytskyi Anatolii F, Dolianytskyi Mykola M, Benzar Irina M

机构信息

BOGOMOLETS NATIONAL MEDICAL UNIVERSITY, KYIV, UKRAINE; NATIONAL CHILDREN'S SPECIALIZED HOSPITAL "OHMATDYT", KYIV, UKRAINE.

BOGOMOLETS NATIONAL MEDICAL UNIVERSITY, KYIV, UKRAINE.

出版信息

Wiad Lek. 2020;73(10):2144-2149.

Abstract

OBJECTIVE

The aim: To chose the best way treatment and achievement of 3-dimensional spinal correction in order to maximize its parameters to the physiological norms is a choice of the optimal surgical severe scoliotic spinal deformity correction technology.

PATIENTS AND METHODS

Materials and methods: Performed surgical treatments to 60 children of two patient's groups, that were under surgical treatment for severe scoliotic spinal deformations with preliminary used halo-gravity traction and one-step correction; to establish an effective and safe protocol of the treatment for children with severe scoliotic spinal deformations (>100°). The results comparative analysis of 60 patients with severe scoliotic spinal deformations, with a two-step surgery treatments (first step - halo-gravity traction and second step - correcting spinal instrumentation) and patients with one-step correction. Patients were divided into 2 groups with 30 children in each of them. The first group treated with preoperatively HGT (halo-gravity traction) and after that a spinal instrumentation together with osteotomies (3-4 levels by Ponte; VCR (vertebral column resection) osteotomy 1 level) were performed. The second group - performed one-step spinal instrumentation with osteotomies (3-4 levels by Ponte; VCR osteotomy 1 level).

RESULTS

Results: One-step implanted construction in children with severe scoliotic spinal deformations, compare to HGT treatment that were carried out in stages - is increasing the danger of neurological deficiency by 17%, HGT allows to make more corrections and to adjust spinal cord for the next correction treatment.

CONCLUSION

Conclusions: Halo-gravity traction as a first stage of severe scoliotic spinal deformations treatment allows to increase the mobility of the vertebral column and to adjust spinal cord step by step for the next correction treatment.

摘要

目的

目的:选择最佳治疗方法并实现三维脊柱矫正,以使脊柱参数最大程度地接近生理标准,这是选择严重脊柱侧弯畸形矫正的最佳手术技术。

患者与方法

材料与方法:对两组共60名儿童进行手术治疗,这些儿童因严重脊柱侧弯畸形接受手术治疗,术前采用头环重力牵引和一步矫正;建立针对严重脊柱侧弯畸形(>100°)儿童的有效且安全的治疗方案。对60例严重脊柱侧弯畸形患者进行两步手术治疗(第一步 - 头环重力牵引,第二步 - 脊柱器械矫正)和一步矫正患者的结果进行对比分析。患者分为两组,每组30名儿童。第一组术前进行头环重力牵引,之后进行脊柱器械植入及截骨术(Ponte法3 - 4个节段;椎体切除术1个节段)。第二组 - 进行一步脊柱器械植入及截骨术(Ponte法3 - 4个节段;椎体切除术1个节段)。

结果

结果:与分阶段进行的头环重力牵引治疗相比,严重脊柱侧弯畸形儿童一步植入器械增加了17%的神经功能缺损风险,头环重力牵引可进行更多矫正并为下一步矫正治疗调整脊髓。

结论

结论:头环重力牵引作为严重脊柱侧弯畸形治疗的第一阶段,可增加脊柱的活动度,并为下一步矫正治疗逐步调整脊髓。

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