scholarly journals Surgery for Idiopathic Scoliosis: Currently Applied Techniques

2009 ◽  
Vol 3 ◽  
pp. CMPed.S2117 ◽  
Author(s):  
Toru Maruyama ◽  
Katsushi Takeshita

This review discusses the basic knowledge and recent innovation of surgical treatment for scoliosis. Surgical treatment for scoliosis is indicated, in general, for a curve exceeding 45 to 50 degrees by the Cobb's method on the basis that: 1. Curves larger than 50 degrees progress even after skeletal maturity. 2. Curves larger than 60 degrees cause loss of pulmonary function, and much larger curves cause respiratory failure. 3. Greater the curve progression, the more difficult it is to treat with surgery. Posterior fusion with instrumentation has been the standard form of surgical treatment for scoliosis. In modern instrumentation systems, more anchors are used to connect the rod and the spine, resulting in better correction and less frequent implant failures. Segmental pedicle screw constructs or hybrid constructs using pedicle screws, hooks, and wires are the trend of today. Anterior instrumentation surgery was once the choice of treatment for thoracolumbar and lumbar scoliosis because better correction could be obtained with shorter fusion levels. But in the recent times, superiority of anterior surgery for the thoracolumbar and lumbar scoliosis has been questioned. Initial enthusiasm for anterior instrumentation for the thoracic curve using video assisted thoracoscopy has faded out.

2008 ◽  
Vol 5 (2) ◽  
pp. 27-31
Author(s):  
Yu I Yashkov ◽  
D K Bekuzarov ◽  
A V Nikol'skiy

A clinical significance in the treatment of bulimia nervosa patients with morbid obesity had already been raised [10, 13], but we did not find publications on the effectiveness of bariatric surgery in these cases. There is also information about the possibility of applying the operation bilio-pancreatic bypass, effective in patients with morbid obesity with uncontrolled eating behavior for the treatment of patients with anorexia BILIM not suffering from morbid obesity. In this article the data of clinical observation of a small sample of patients. As a result, the treatment of these patients found that severe nervous BILIM can be seen as a latent form of morbid obesity. The choice of treatment should depend not only on the initial body weight of the patient, but also on the severity of the nervous BILIM. Unsuccessful attempts at organized-balanced, conservative treatment of patients with severe bulimia nervosa may be considered a variant of surgical treatment, while bilio-pancreatic bypass surgery is considered as the most preferred operation, compared with the installation of the gastric balloon and others. All candidates for surgical treatment of obesity must identify clinical signs of bulimia nervosa, as this may influence the choice of method of operation. Further study of the role of hyperinsulinemia, secretion of ghrelin, leptin, intestinal peptide may contribute to the elucidation of the true causes of bulimia nervosa, probably has a similar origin with morbid obesity.


2020 ◽  
Vol 24 (3) ◽  
pp. 132
Author(s):  
U. G. Kolbik ◽  
A. V. Gorustovich ◽  
Yu. I. Linnik ◽  
M. M. Shved ◽  
V. V. Drozdovskaya ◽  
...  

<p>This publication presents the clinical observation in a paediatric patient with haemangioma of the left stomach. The effectiveness of surgical treatment of this disease is also noted. We assess the challenges in diagnosis and the choice of treatment of this pathology in children and the effectiveness of surgical treatment disease.<br />Primary cardiac tumours are rare; vascular tumours and haemangiomas are rarer. The clinical picture of heart haemangioma is non-specific and varies as per its location and size. Echocardiography is the main diagnostic method for this disease. However, in most cases of preoperative diagnostic examination, the pre-surgery diagnosis is not confirmed. The final diagnosis of capillary haemangioma is established following immunohistochemical staining of the surgical material. Thus far, owing to the rare occurrence, a generally accepted tactic for the treatment of such patients with vascular heart tumours has not been developed.<br />This clinical case describes our experience of treating a rare pathology in children with unusual localisation as well as the rapid successful surgical removal of the tumour without complications and with a favourable post-surgery recovery period.</p><p>Received 14 May 2020. Revised 15 June 2020. Accepted 26 June 2020.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p><p><strong>Author contributions</strong> <br />Literature review: U.G. Kolbik, A.V. Gorustovich, Y.I. Linnik<br />Illustrations: U.G. Kolbik, I.V. Sakharov, V.V. Drozdovskaya <br />Drafting the article: U.G. Kolbik, A.V. Gorustovich, I.V. Sakharov<br />Critical revision of the article: I.V. Sakharov, M.M. Shved, Yu.I. Linnik<br />Surgical treatment: A.V. Gorustovich, M.M. Shved, U.G. Kolbik<br />Final approval of the version to be published: U.G. Kolbik, A.V. Gorustovich, Yu.I. Linnik, M.M. Shved, V.V. Drozdovskaya, <br />I.V. Sakharov, K.V. Drozdovski</p>


2016 ◽  
Vol 15 (1) ◽  
pp. 22-25
Author(s):  
Natalia Sergeyevna Morozova ◽  
Dmitriy Aleksandrovich Kolbovsky ◽  
Arkadiy Ivanovich Kazmin ◽  
Sergey Vasilievich Kolesov

ABSTRACT Objectives: To compare the outcomes of surgical treatment with lumbar fixation using nitinol rods without fusion and with standard lumbar fixation with titanium rods and interbody fusion. Methods: Treatment results of 70 patients with degenerative lumbar scoliosis aged 40 to 82 were analyzed. In all cases pedicle screws and nitinol rods with a diameter of 5.5 mm were used. Thirty patients underwent fixation at L1-S1 and 40 patients underwent fixation at L1-L5. Spinal fusion was not performed. All patients had radiography, CT and MRI performed. The results were assessed according to the Oswestry scale, SRS 22, SF 36 and VAS. The minimum follow-up period for all patients was 2.5 years. For the control group, consisting of 72 patients, pedicle fixation with titanium rods and interbody fusion in the lumbosacral region were performed. Results: The average level of deformity correction equaled 25° (10° - 38°). The analysis of X-ray and CT-scans revealed a single patient with implant instability, two patients with bone resorption around the screws and one patient with rod fractures. Functional radiography 2.5 years after surgery showed an average mobility of the lumbar spine of 21° (15° - 30°). There were no problems at the adjacent levels. Conclusions: The use of nitinol rods in spinal deformity surgery is promising. This technology is an alternative to rigid fixation. Continued gathering of clinical data and its further evaluation is necessary.


2016 ◽  
Vol 24 (3) ◽  
pp. 398-401 ◽  
Author(s):  
Sang-Hyun Han ◽  
Seung-Jae Hyun ◽  
Tae-Ahn Jahng ◽  
Ki-Jeong Kim

Spontaneous bilateral pedicle fractures of the lumbar spine are rare, and an optimal surgical treatment has not been suggested. The authors report the case of a 50-year-old woman who presented with low-back pain and right leg radiating pain of 1 year’s duration. Radiological studies revealed a spontaneous bilateral pedicle fracture of L-5. All efforts at conservative treatment failed, and the patient underwent surgery for osteosynthesis of the fractured pedicle using bilateral pedicle screws connected with a bent rod. Her low-back and right leg pain were relieved postoperatively. A CT scan performed 3 months postoperatively revealed the disappearance of the pedicle fracture gap and presence of newly formed bony trabeculation. In rare cases of spontaneous bilateral pedicle fracture of the lumbar spine, osteosynthesis of the fractured pedicle using bilateral pedicle screws and a bent rod is a motion-preserving technique that may be an effective option when conservative management has failed.


2000 ◽  
Vol 21 (10) ◽  
pp. 825-832 ◽  
Author(s):  
Francesco Ceccarelli ◽  
Cesare Faldini ◽  
Franco Piras ◽  
Sandro Giannini

This study compared surgical and non-surgical treatment of 46 calcaneal fractures in children aged 3-17 years. Patients were divided into: Group A ranging 3-14 years and Group B 15-17 years, and classified according to surgical or non-surgical treatment. Mean follow-up was 22.8 years. Extra-articular fractures were treated non-surgically and all results were satisfactory. Results of articular fractures in Group A were satisfactory regardless of the type of treatment. Articular fractures surgically treated in group B were satisfactory, and those non-surgically treated were mainly poor. Extra-articular fractures can be treated non-surgically. Articular fractures in skeletally immature children can be treated non-surgically; conversely, those in children with skeletal maturity must be treated surgically.


2012 ◽  
Vol 61 (3) ◽  
pp. 355-361
Author(s):  
Yoshikazu Yanagisawa ◽  
Hiroshi Nomura ◽  
Atsuko Kohyama ◽  
Kensuke Hotta ◽  
Satoshi Kido ◽  
...  

2018 ◽  
Vol 12 (1) ◽  
pp. 47-54
Author(s):  
C. Mallet ◽  
A. Abitan ◽  
C. Vidal ◽  
L. Holvoet ◽  
K. Mazda ◽  
...  

Purpose Sickle cell disease (SCD) is the most common cause of femoral head osteonecrosis (ONFH) during childhood with an overall prevalence of 10%. In children, spontaneous revascularization can occur, as in Legg-Calve-Perthes disease. Consequently, the aim of treatment is to restore proper hip containment to prevent joint arthritis. This is the first study reporting long-term results at skeletal maturity of non-operative and surgical treatments for ONFH in SCD children. Methods All children with ONFH due to SCD were retrospectively reviewed. At initial evaluation, extension of osteonecrosis was radiographically defined using Catterall, lateral pillar Herring and Ficat classifications. Subluxation of the femoral head with Reimers migration index > 30% required surgical treatment including femoral varus osteotomy and/or pelvic osteotomies. Conservative treatment including non-weight bearing and physiotherapy was performed in the remaining cases. Outcomes were assessed at skeletal maturity using the Harris Hip Score (HHS) and the Stulberg classification. Total hip arthroplasty and Stulberg 5 were defined as failures. Results A total of 25 hips in 17 patients were included (mean follow-up 7.5 years SD 3.4). Mean age at diagnosis was 11.4 years SD 2.9. In all, 15 hips (60%) were classified Catterall 3 and 4 and Herring B and C. A total of 13 patients (52%) underwent surgical treatment. At skeletal maturity, mean HHS was good (81 SD 17), 12 hips (48%) were classified Stulberg 1 and 2, seven hips (28%) were classified Stulberg 3 and 4. Conclusion Both treatments led to good functional results with 75% of congruent hips at skeletal maturity. Level of Evidence IV


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