Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca

Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca

Původní práce / Original papers

ACTA CHIRURGIAE ORTHOPAEDICAE ET TRAUMATOLOGIAE ČECHOSL.,
85, 2018, p. 89 - 93

Systémy usměrňovaného růstu v léčbě raných dětských skolióz

Growth Guidance System in Treatment of Early Onset Scoliosis

M. REPKO1, M. FILIPOVIČ1, M. PRÝMEK1, M. LATALSKI2, A. ŠPRLÁKOVÁ-PUKOVÁ3, J. HOŘÁK1
1 Ortopedická klinika Lékařské fakulty Masarykovy univerzity a Fakultní nemocnice Brno
2 Department of Pediatrie Orthopaedics, University Children´s Hospital in Lublin, Poland
3 Klinika radiologie a nukleární medicíny Lékařské fakulty Masarykovy univerzity a Fakultní nemocnice Brno

ABSTRACT

PURPOSE OF THE STUDY

The Growth Guidance System (GGS) represent a relatively new alternative to the traditional growing systems used for the treatment of early onset scoliosis. Ranking among the main aims of this surgical treatment is a three-dimensional correction of the deformity, maintenance of spinal growth and postponement of the necessity of final treatment by spondylodesis.

MATERIAL AND METHODS

Our study retrospectively evaluates the results of surgical correction in a  group of 35 patients treated by GGS technique. The group consisted of patients with idiopathic, neuromuscular and syndromic spine deformity with the average age of 8 years and 2 months at the time of the surgery. The time of the follow-up is 3 years and 5 months on average. We evaluated the correction of the curve itself, the growth of the spine measured in the thoracic and lumbar part separately, and the growth of the trunk as a whole in the mentioned range on X-ray pictures.

RESULTS

The average correction of the scoliotic curve was 67%, from 75 preoperative degrees to 20 postoperative degrees. After the first operation 11% elongation of the trunk (from 321 mm to 356 mm) was reached, the thoracic spine was elongated by 10% (from 196 to 217 mm) and the lumbar spine was elongated by 11% (from 125 to 139 mm). The elongation of the trunk by 16% (from 322 to 375 mm) was observed in the cohort of patients with two years postoperative follow-up (21 patients). The total protraction of the trunk by 21% (from 318 to 386 mm) was reached in patients treated by definitive fusion (7 patients).

DISCUSSION

There is a very low number of studies analysing the long-term clinical results with the use of GGS. The first pilot results indicate that it is a technique allowing to achieve at least comparable results in correction of frontal plane compared with the distraction type of instrumentations. A negative aspect of this method is the abrasion of metal followed by metallosis. The new types of fixation screws enable more effective sliding of rods, maintenance of continuity of body grow by the shifting of rods as well as lower abrasion of the instrumentation.

CONCLUSIONS

The main advantage of GGS is the limited continuous growth of the spine, partial three-dimensional correction of the deformity, minimisation of inevitable reoperations under general anaesthesia and the possibility to quit a brace.

Key words: growth guided system, early onset scoliosis, distraction, spinal growth, spondylodesis

Zpět


Nabídka nakladatelství:

 

Peter Wendsche, Radek Veselý et al.
Traumatologie

Traumatologie

 

Oldřich Čech, Pavel Douša, Martin Krbec et al.
Traumatologie pohybového aparátu, pánve, páteře a paklouby

Traumatologie pohybového aparátu, pánve, páteře a paklouby

 

Petr Chládek
Femoroacetabulární impingement syndrom

Femoroacetabulární impingement syndrom