| Abstrakt: |
Introduction. In neuromuscular disorders, as a result of muscle strength decrease, there is the risk of developing scoliosis. Considering the impossibility of ensuring the correct and constant application of the conservative treatment, the appearance and evolution of scoliosis are independent of it. Therefore, wearing a corset will not prevent the development of neuromuscular scoliosis. Material and Methods. A 14-year-old male patient was diagnosed with spinal muscular atrophy (SMA) type II and had indications for wearing a corset. The patient's compliance with the conservative treatment and the evolution of scoliosis in time were not monitored. Therefore, the surgical intervention was inefficiently timed. Presented in our center with Cobb angle turaco-lumbar scoliosis more than 150 degrees, was rapidly oriented to the department of spinal surgery with the indication of surgical correction. In view of the comorbidities (SMA, respiratory insufficiency), the dorsal approach was chosen for spinal correction. Given the collapsing spine, with marked vertebrae rotations, pelvic oblique and marked curvature stiffness, the correction could only be partial. The goal was not a complete correction, but basin horizontalization, restoration of an optimal sagittal profile, balance of the column and body, respectively (and not least) the fusion. Dorsal correction was performed with instrumentation from the T2 level to the ilium bone with posterior spondylodesis and Ponte osteotomies in apex curvatures. Results. Following the spinal surgery, performed in the clinic SRH Klinikum Karlsbad-Langensteinbach, the patient regains his ability to sit independently, without external lateral support, thus contributing to improving his quality of life and avoiding the accentuation of the restrictive respiratory insufficiency due to the marked deformities. Conclusion. In order to obtain best results, it is necessary to know the ideal moment for the application of all therapeutic measures, including the surgical intervention. Patients must be carefully monitored for the most indicated moment of scoliosis sanction.. [ABSTRACT FROM AUTHOR] |
