Surgical treatment of kyphosis in children with scheuermann’s diseaseusing 3D-CT navigation

Sergei Valentinovich Vissarionov; Dmitriy Nikolaevich Kokushin; Sergei Mikhailovich Belyanchikov; Vladislav Valerievich Murashko

doi:10.17816/PTORS315-14

Pediatric Traumatology, Orthopaedics and Reconstructive Surgery ›› 2015, Vol. 3 ›› Issue (1) : 5 -14. DOI: 10.17816/PTORS315-14

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Surgical treatment of kyphosis in children with scheuermann’s diseaseusing 3D-CT navigation

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The Turner Institute for Children’s Orthopedics, Saint-Petersburg

MD, PhD, professor, Deputy Director for Research and Academic Affairs, head of the department of spinal pathology and neurosurgery. FSBI “Scientific and Research Institute for Children’s Orthopedics n. a. G. I. Turner” under the Ministr y of Health of the Russian Federation. Professor of the chair pediatric traumatology, orthopedics and surgeon. State budget institution of higher education “North-Western State Medical University n. a. I. I. Mechnikov” under the Ministry of Health of the Russian Federation.

MD, research associate of the department of spinal pathology and neurosurgery. FSBI “Scientific and Research Institute for Children’s Orthopedics n. a. G. I. Turner” under the Ministry of Health of the Russian Federation

MD, PhD, chief of the department of spine pathology and neurosurgery. FSBI “Scientific and Research Institute for Children’s Orthopedics n. a. G. I. Turner” under the Ministry of Health of the Russian Federation.

MD, orthopedic and trauma surgeon of the department of spine pathology and neurosurgery. FSBI "Scientific and Research Institute for Children’s Orthopedics n. a. G. I. Turner” under the Ministry of Health of the Russian Federation

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Abstract

The purpose of the study is to describe features of the surgical technique for correction of kyphotic deformity of the spine and to analyze the results of surgical treatment of juvenile kyphosis in children with the use of 3D-CT navigation. Materials and methods. We observed 11 patientsaged 14-17 years old (2 girls and 9 boys) with kyphoticdeformity of the spine, developed on the backgroundof Scheuermann’s disease. The deformity amount aver-aged 73,9° (60 to 90°). Surgery was performed fromthe combined access, carring out discapophysectomyand corporodesis on top of kyphosis and fixing mul-tibasic corrective metal construction. For the insertionof pedicle screws we used 3D-CT navigation. The results. After surgery kyphosis value decreasedto 32,6° (20 to 45°), the deformity correction averaged41,3° (30 to 50°). Hybrid systems were placed in 5 pa-tients, total transpedicular fixation - in 6 children.Number of fixed vertebrae with hybrid metal construc-tions averaged 14 (13 to 15), in patients with total pediclefixation - 13 (12 to 14). In all cases we observed the correct position of pedicle support elements. Postopera- tive follow-up period was from 1 year and 5 months to5 years and 4 months, on average - 3 years 5 months. The loss of the result achieved in the long-term follow- up period was observed in patients with hybrid metal constructions and averaged 7,2° (4 to 9°). Conclusion. The use of pedicle screws for thecorrection of juvenile kyphosis in children allows forthe effective correction of the deformity, restoring thephysiological profiles of the spine, eliminating post-operative progression of curvature, and reducing thelength of metal fixation and save the result achievedin the long-term follow-up. The use of active optical3D-CT navigation allows carring out a correct inser-tion of pedicle screws in the vertebral bodies in chil-dren with juvenile kyphosis. Keywords: Scheuermann’s disease, juvenile ky-phosis, transpedicular fixation, navigation, children,surgical treatment.

Keywords

Scheuermann’s disease / juvenile ky-phosis / transpedicular fixation / navigation / children / surgical treatment

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Sergei Valentinovich Vissarionov, Dmitriy Nikolaevich Kokushin, Sergei Mikhailovich Belyanchikov, Vladislav Valerievich Murashko. Surgical treatment of kyphosis in children with scheuermann’s diseaseusing 3D-CT navigation. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery, 2015, 3(1): 5-14 DOI:10.17816/PTORS315-14

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