| Autor: |
H M, Lorenz, L, Braunschweig, I M, Eberhardt, K, Tsaknakis, A-K, Hell |
| Jazyk: |
němčina |
| Rok vydání: |
2018 |
| Předmět: |
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| Zdroj: |
Operative Orthopadie und Traumatologie. 31(4) |
| ISSN: |
1439-0981 |
| Popis: |
Reduction and retention of the scoliotic curve in children with progressive spinal deformities.Progressive neuromyopathic scoliosis which cannot be controlled conservatively (especially by walking disability), and/or development of a thorax insufficiency syndrome (TIS).Insufficient soft tissue coverage; body weight 11.4 kg; body mass index (BMI) 25 or50 kg; missing osseous anchoring structures (ribs); adult skeleton (usually age 12 years at surgery); severe spasticity.Indirect correction and distraction of the spinal deformity by two extendable, paravertebral telescopic implants, anchored to the cranial ribs and the iliac crest; the spine is not compromised surgically.Early functional therapy, no brace; multiple surgical (VEPTR®-system) or externally (magnetically controlled rods) controlled extensions per year.The surgical paravertebral "no-touch" technique for spine correction is particularly suitable for children with neuromyopathic scoliosis with a body weight 11.4 kg. Our prospective group of children (n = 45), was treated with a combination of the classic vertical expandable prosthetic titanium rib (VEPTR®) anchored to the ribs and iliac crest combined with a magnetically controlled telescopic implant (MAGEC®). The primary correction of50% was achieved, while progression was effectively prevented over years. In 495 outpatient lengthening procedures, the rate of implant-associated complications requiring surgery was 3.7%. Of the 45 children, 13 (29%) underwent surgical revision. With the proposed surgical "no-touch" technique for scoliosis correction of pediatric neuromyopathic deformities, an effective reduction of the scoliotic curve can be achieved and maintained. Advantages of the method are a partial retention of spinal flexibility and a reduction of spinal ossifications, which facilitates dorsal spondylodesis as the final treatment. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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