Tello C A
Spine Unit, Garrahan Children's Hospital, Buenos Aires, Argentina.
Orthop Clin North Am. 1994 Apr;25(2):333-51.
The treatment of severe spinal deformities in childhood is a great challenge. The nonoperative treatment is not always successful, and correction with spinal fusion is not usually the most desirable goal because it may result in a straighter but shorter trunk. Spinal instrumentation without arthrodesis is an alternative to these difficult decisions that allows child growth with control of the deformity. At the same time that there is considerable improvement in the natural history of these deformities, this treatment presents great morbidity. The combination of Harrington instrumentation and consecutive distractions is a difficult program but it has been the best answer for these complicated patients up to now.
儿童严重脊柱畸形的治疗是一项巨大挑战。非手术治疗并非总能成功，而通过脊柱融合进行矫正通常并非最理想的目标，因为这可能导致躯干变直但变短。不进行关节融合的脊柱内固定是替代这些艰难决策的一种选择，它能在控制畸形的同时让儿童生长。尽管这些畸形的自然病程有了相当大的改善，但这种治疗仍存在很高的发病率。哈灵顿器械与连续撑开相结合是一个艰难的方案，但到目前为止，它一直是这些复杂患者的最佳解决方案。
