Orthopaedics & traumatology, surgery & research : OTSR · 2020
Posterior vertebral column resection for pediatric rigid spinal deformity.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ould-Slimane Mourad, Hossein Nabian Mohammad, Simon Anne-Laure, Happiette Adèle, Julien-Marsollier Florence, Ilharreborde Brice
Аннотация
INTRODUCTION: Surgery for pediatric spinal deformity may involve vertebral osteotomies in complex cases. Vertebral column resection (VCR) is the most technically demanding procedure, with the severest morbidity. It can use a double anterior and posterior approach (APVCR), though a single posterior approach (PVCR) is gaining in popularity.
HYPOTHESIS: PVCR provides effective correction with acceptable morbidity in children.
METHOD: A single-center retrospective series included spinal deformities treated by PVCR. Surgical data and global pelvic-spinal balance parameters were analyzed.
RESULTS: Sixteen PVCRs were performed in 13 patients, with a mean age of 14.1±2.8 years. Mean operative time was 411±54minutes. Mean preoperative rigid principal Cobb angle was 74.3°. Mean correction was 64.3% postoperatively, without significant correction loss at last follow-up. Mean blood loss was 941±221ml. The cell-saver enabled 92.3% autologous transfusions, with 53.4% homologous transfusions. Transient monoplegia and permanent psoas deficit were observed during the postoperative period. Radiologic follow-up found 4 non-unions requiring revision.
CONCLUSION: PVCR provided major correction of rigid spinal deformity in children. Complications mainly comprised mechanical or neurological incidents.
LEVEL OF EVIDENCE: IV, non-comparative cohort study.
HYPOTHESIS: PVCR provides effective correction with acceptable morbidity in children.
METHOD: A single-center retrospective series included spinal deformities treated by PVCR. Surgical data and global pelvic-spinal balance parameters were analyzed.
RESULTS: Sixteen PVCRs were performed in 13 patients, with a mean age of 14.1±2.8 years. Mean operative time was 411±54minutes. Mean preoperative rigid principal Cobb angle was 74.3°. Mean correction was 64.3% postoperatively, without significant correction loss at last follow-up. Mean blood loss was 941±221ml. The cell-saver enabled 92.3% autologous transfusions, with 53.4% homologous transfusions. Transient monoplegia and permanent psoas deficit were observed during the postoperative period. Radiologic follow-up found 4 non-unions requiring revision.
CONCLUSION: PVCR provided major correction of rigid spinal deformity in children. Complications mainly comprised mechanical or neurological incidents.
LEVEL OF EVIDENCE: IV, non-comparative cohort study.