SURGICAL MANAGEMENT OF CHILDREN WITH SEVERESCOLIOSIS

摘要

IMPROVEMENT OF QUALITY OF LIFE AT CHILDREN WITHSERIOUS SCOLIOTIC DEFORMATIONS BY DEVELOPMENT OF DIFFERENTIATEDSURGICAL TACTICS.MATERIAL AND METHODS: 109 PATIENTS WITH SEVERE SCOLIOTICDEFORMATIONS HAVE BEEN PRE- AND POSTOPERATIVELY EXAMINED. THEEVALUATION INCLUDED COLLECTING OF ANAMNESIS DATA, CLINICALEXAMINATION, LABS AND IMAGING (STANDARD RADIOGRAPHY/ WITHFUNCTIONAL TESTS, MAGNETIC RESONANCE) WITH A FOLLOW-UP OF 1 TO 10YEARS. CHILDREN WERE AGED BETWEEN 5 AND 17 YEARS; THEY WEREPREDOMINANTLY GIRLS – 69(76 %).RESULTS: THE MAIN GOALS OF SURGICAL INTERVENTIONS WERE: ELIMINATIONOF THE COMPRESSION FACTOR, DEFORMATION AND DISBALANCE CORRECTIONAND SPINE STABILIZATION.THE DISTANT RESULTS OF SURGICAL TREATMENT WERE GOOD – 68,4%,SATISFACTORY – 24,1%AND UNSATISFACTORY – 3,5%.CONCLUSION:1.OPTIMUM METHODS OF CORRECTION OF DIFFICULT RIGID SCOLIOTIC SPINEDEFORMATIONS WERE: FORWARD SPINE RELEASE; DORSAL CORRECTION, TOTALFASETEKTOMY (THE BOTTOM AND TOP FACING) THROUGHOUT CORRECTION BYPONTUS' METHOD AND BACKBONE FIXATION BY A METAL CONSTRUCTION.2. SURGICAL TREATMENT OF DIFFICULT JUVENILE SCOLIOSES BEGAN AT 8-10YEARS OLD, WITH THE FOLLOWING DORSAL CORRECTION BY "A GROWINGCONSTRUCTION", WITHOUT POSTERIOR SPINE FUSION EXECUTION.3. IN CASES OF CONGENITAL DEFORMATIONS PRIMARY OPERATIVE DEFECT’SCORRECTION WAS CARRIED OUT AT CHILDREN AT THE AGE OF 5-7 YEARS –"BLOCKING SPONDYLOSYNDESIS" AT CURVATURE TOP WITH THE FOLLOWINGDORSAL CORRECTION BY "A GROWING CONSTRUCTION" WITHOUT POSTERIORSPINE FUSION EXECUTION.