METHOD FOR CROSS-CORE CORRECTION OF NEUROMUSCULAR KYPHOSCOLIOSIS WITH SIMULTANEOUS CORRECTION OF THE PELVIC OBLIQUITY AND THORACOCERVICAL SPINE

摘要

FIELD: medicine.;SUBSTANCE: invention relates to medicine and can be used for cross-core correction of neuromuscular kyphoscoliosis with simultaneous correction of the pelvic obliquity and thoracocervical spine. Transpedicular placement of screws is being performed in the vertebrae C₇, Th₁, Th₂, Th₃, Th₄ and Th₅ on both sides, as well as placement of screws in the vertebrae L₂, L₃, L₄, L₅, S₁ and in the iliac bones on both sides. First long rod is being modeled in accordance with individual lordosis and kyphosis in the patient's wound with the trajectory of rod modeling according to the form of vertebrae deformation L₂, L₃, L₄, L₅, S₁ and iliac bone on the right and according to the form of vertebrae deformation C₇, Th₁ Th₂, Th₃, Th₄ and Th₅ – on the left. First modeled long rod is being placed on the vertebrae screws according to the length of the vertebral column deformation from the vertebra L₂, L₃, L₄, L₅, S₁ and the iliac bone on the right to the vertebrae C₇, Th₁, Th₂, Th₃, Th₄ and Th₅ on the left and a preliminary incomplete tightening of the nuts on the screws of vertebrae is being performed. First modeled long rod is being finally fixed by tightening the nut on the vertebra L₂ screw on the right. Segment distraction of vertebrae L₃, L₄, L₅, S₁ and iliac bone is being performed, first distraction of vertebra L₃ from vertebra L₂ is being performed with final fixation of the nut on the vertebra L₃ screw, distraction of vertebra L₄ from vertebrae L₃ is being performed with final fixation of the nut on the vertebra L₄ screw, distraction of vertebra L₅ from vertebra L₄ is being performed with final fixation of the nut on the vertebra L₅ screw, distraction of vertebra S₁ from vertebra L₅ is being performed with final fixation of the nut on the vertebra S₁ screw, distraction of the iliac bone S₁ with final fixation of the nut on the iliac bone screw, at the same time, a predetermined correction of the pelvic obliquity is provided, the final fixation of the first modeled long rod is performed by tightening the nut on the vertebra Th₅ screw on the left, then a segment distraction of the vertebrae C_7th, Th₁, Th₂, Th₃, Th₄ and Th₅, is being performed, first, distraction of the vertebra Th₄ from vertebra Th₅ with the final fixation of the nut on the vertex Th₄ screw, distraction of vertebra Th₃ from vertebra Th₄ is being performed with the final fixation of the nut on the vertebra Th screw₃, distraction of vertebra Th₂ from vertebrae Th₃ is being performed with final fixation of the nut on the vertebra Th₂ screw, distraction of vertebra Th₂ from vertebra Th₁, is being performed with final fixation of the nut on the vertebra Th₁, screw, distraction of vertebra C₇ from vertebra Th₁ is being performed with the final fixation of the nut on the vertebra C₇ screw, while providing a given correction of the thoracocervical spine. Second long fixing rod is being modeled according to the length from vertebra C₇ on the right to the iliac bone in the wound of the patient with the trajectory of the bending of the second long fixing rod according to the form of the corrected spine. Second long modeled fixing rod is being placed on the vertebrae screws of the corrected vertebral column from vertebrae L₂, L₃, L₄, L₅, S₁ and iliac bone on the left to vertebrae C₇, Th₁, Th₂, Th₃, Th₄ and Th₅ on the right and the final fixation of the second long fixing rod on the screws of the vertebrae is being performed by tightening the nuts. After arkotomy, arthrotomy and partial resection of the base of spinous processes and creating posterior spondylodesis with bone grafts with osteomatrix, a transverse fixing metal plate is being placed on both rods at the level of vertebra L₁ and rigidly fixed on both rods.;EFFECT: method provides reduced time of surgical intervention and reliable stabilization.;3 cl, 2 ex