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Post a Comment Surgical treatment of advanced congenital kyphoscoliosis: A case report
- Authors: Kosulin A.V.1, Elyakin D.V.1, Dmitrieva N.N.1, Abzalieva A.D.1, Blazhenko A.A.1, Volchenko L.V.1
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Affiliations:
- St. Petersburg State Pediatric Medical University
- Issue: Vol 9, No 3 (2018)
- Pages: 118-123
- Section: Articles
- URL: https://journal-vniispk.ru/pediatr/article/view/9141
- DOI: https://doi.org/10.17816/PED93118-123
- ID: 9141
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Abstract
Clinical case of surgical treatment of advanced congenital kyphoscoliosis in 12 years old child is reported. Radiographs and CT at presentation failed to reveal the entire anomaly. By analysis of priorly made radiographs hemivertebra L1 was recognized. At genitourinary assessment L-shaped kidney was detected. A full-size 3D-printed model was used for surgical planning. Vertebral column resection as treatment option was discussed, but due to high neurologic complication rate this approach was refused. After preoperative 35 days halo-femoral traction anterior instrumented fusion was performed. Right ureter was stented for intraoperative urologic injury prevention. Scoliosis correction of 32% and kyphosis of 14% was achieved. 5 months later definitive posterior uninstrumented fusion was performed. Spinal deformities caused by vertebral malformations progress dramatically unless they are treated early. An advanced case is a clinical challenge because of technical difficulties and poor result. Vertebral column resection is a treatment option for severe kyphoscoliosis, but it’s indications should be strictly individualized. Preoperative halo-femoral traction is the most safe correction method in spinal deformity due to prolonged and gradual action. 3d-printed models are practical for surgical planning. The model may be used intraoperatively as a 3D-reference. In congenital scoliosis genitourinary system should be assessed meticulously, and urologist advice in relevant case is necessary.
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##article.viewOnOriginalSite##About the authors
Artem V. Kosulin
St. Petersburg State Pediatric Medical University
Author for correspondence.
Email: hackenlad@mail.ru
Assistant Professor, Department of Operative Surgery and Topographic Anatomy
Russian Federation, Saint PetersburgDmitriy V. Elyakin
St. Petersburg State Pediatric Medical University
Email: dimaelkins@mail.ru
Pediatric Surgeon, Surgical Department No 2
Russian Federation, Saint PetersburgNadezhda N. Dmitrieva
St. Petersburg State Pediatric Medical University
Email: nadegdanik86@gmail.com
Resident Doctor, Department of Surgical Diseases of Childhood
Russian Federation, Saint PetersburgAlina D. Abzalieva
St. Petersburg State Pediatric Medical University
Email: a.abzalieva@gmail.com
Student, Department of Operative Surgery and Topographic Anatomy
Russian Federation, Saint PetersburgAleksandra A. Blazhenko
St. Petersburg State Pediatric Medical University
Email: alexandrablazhenko@gmail.com
Student, Department of Operative Surgery and Topographic Anatomy
Russian Federation, Saint PetersburgLyubov V. Volchenko
St. Petersburg State Pediatric Medical University
Email: volchenko.lyubov@mail.ru
Student, Department of Operative Surgery and Topographic Anatomy
Russian Federation, Saint PetersburgReferences
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