RŮSTOVÉ TYČE V LÉČBĚ RANÉ SKOLIÓZY: RETROSPEKTIVNÍ STUDIE DVOU SKUPIN Z LET 1981 - 2015
| Title in English | GROWING RODS AS A TREATMENT OF EARLY ONSET SCOLIOSIS: RETROSPECTIVE STUDY OF TWO GROUPS 1981 - 2015 |
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| Authors | |
| Year of publication | 2018 |
| Type | Article in Periodical |
| Magazine / Source | Ortopedie (Praha) |
| MU Faculty or unit | |
| Citation | |
| Web | časopis |
| Keywords | scoliosis growing rods distraction |
| Description | ABSTRACT Objectives: The goal of this study is to retrospectively compare findings in two groups of patients treated for early scoliosis with repeated distraction surgery using single-rod instrumentation. Material and Methods: The sample for this research consisted of 177 patients with the average age being 6.5 years (2-15) distributed into two groups. Both groups were treated with repeated distraction without fusion. The first group (152 patients) was surgically treated between the years 1981 – 2006. The second group was surgically treated between the years 2007-2015 (25 patients). The study compares operative techniques, findings and postoperative complications. Each patient was compared for pre-operational X-rays, 5-day postoperative X-rays and following distractions until going for final treatment. Measured parameters in X-ray images were in anteroposterior projection and side projection of long spine X-rays. The study measures the heaviness of scoliotic deformity according to Cobb and also the angle of thoracic kyphosis, lumbar kyphosis, and the C7 plumb line. Included in the study was measurement assessment and interpretation of these findings followed. Results: Postoperative complications when using newer titanium instrumentation with a bigger diameter of the distraction rod and a self-fixation hook in the second observed group significantly decreased. In the first group, the complications accumulated up to 52% owing to hook luxation, fractures of spinal rods or deep infection. In the second group, complications decreased to 12%. Discussion: This study compares single-rod distraction techniques when treating early onset scoliosis and critically assesses the growing rod method which is further statistically studied in detail. The study of international literature is in correlation with our findings and the ratio of complications is significantly lower. Conclusion: After the sample evaluation, it is essential for repeated re-distractions without fusion to use titanium instrumentation with a bigger distraction rod diameter and a self-fixation hook. That way, luxation complications of the upper hook have been eliminated and at the same time, the use of smooth titanium rods of 6mm in diameter led significantly to the decrease of rod fracture hazard compared to the Harrington rod type. The overall stronger construction and the implant allow for the outer thoracic fixation with plaster corset in the postoperative period to be replaced by a plastic brace, which significantly improves patient’s comfort. |