Wiadomosci lekarskie (Warsaw, Poland : 1960) · 2020
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.
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Rohozynskyi Valentyn A, Levytskyi Anatolii F, Dolianytskyi Mykola M, Benzar Irina M
Аннотация
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.
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.