ЕСТЕСТВЕННОЕ ТЕЧЕНИЕ ВРОЖДЕННОЙ ДЕФОРМАЦИИ ПОЗВОНОЧНИКА У ДЕТЕЙ С ИЗОЛИРОВАННЫМ НАРУШЕНИЕМ ФОРМИРОВАНИЯ ПОЗВОНКА В ПОЯСНИЧНОМ ОТДЕЛЕ

Q3 Medicine Hirurgia Pozvonochnika Pub Date : 2018-03-30 DOI:10.14531/SS2018.1.6-17
Сергей Валентинович Виссарионов, Кирилл Александрович Картавенко, Дмитрий Николаевич Кокушин
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引用次数: 3

Abstract

Objective. To assess the natural history of the lumbar spine deformity progression in children with isolated vertebral body malformation. Material and Methods . The natural course of spinal deformity associated with disrupted lumbar vertebra formation was analyzed in 40 patients aged 1 year 7 months to 17 years 11 months who received conservative treatment and dynamic follow-up during four years. Spondylography was performed in frontal and lateral projections in lying position every 6 months. Spondylograms were used to measure the magnitude of the angle of the local scoliotic and kyphotic components of deformity in the process of child’s growth and the magnitude of the angle of general lumbar lordosis. Results. The study showed that two components of deformity (scoliosis and kyphosis) were characterized by a progressive and stable course. Against the background of local curvature in the sagittal plane, the results of the study of general lordosis were distributed according to the age norm and to a flattening relative to the norm at the time of the last observation. Conclusion. At the primary examination of a patient, the initial magnitude of scoliotic curvature according to Cobb plays a predictive role in determining the further course of spinal deformity. When the magnitude of the primary curve is less than 30°, conservative therapy provides a stable course of congenital curvature, and in some children, a tendency to self-correction. Children with initial magnitude of the primary scoliotic curve of more than 30° have steady progression of congenital deformity in the lumbar spine of more than 6° during 4 years, which is an indication for surgical treatment at an early age.
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腰部脊柱形成孤立障碍儿童先天性脊柱畸形的自然过程
客观的评估孤立性椎体畸形儿童腰椎畸形进展的自然史。材料和方法。对40名年龄在1岁7个月至17岁11个月之间的患者进行了分析,这些患者在4年内接受了保守治疗和动态随访。每6个月进行一次脊椎造影术,以平躺姿势进行额侧投影。脊椎图用于测量儿童生长过程中局部脊柱侧弯和后凸畸形成分的角度大小,以及一般腰椎前凸角度大小。后果研究表明,畸形的两个组成部分(脊柱侧弯和后凸)以渐进和稳定的过程为特征。在矢状面局部弯曲的背景下,一般前凸的研究结果根据年龄标准分布,并相对于最后一次观察时的标准变平。结论在对患者进行初步检查时,根据Cobb的说法,脊柱侧弯的初始幅度在确定脊柱畸形的进一步过程中起着预测作用。当主曲线的幅度小于30°时,保守治疗提供了一个稳定的先天性弯曲过程,在一些儿童中,有自我矫正的倾向。原发性脊柱侧弯初始幅度超过30°的儿童在4年内腰椎先天性畸形的发展稳定在6°以上,这是早期手术治疗的一个指征。
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来源期刊
Hirurgia Pozvonochnika
Hirurgia Pozvonochnika Medicine-Anesthesiology and Pain Medicine
CiteScore
0.60
自引率
0.00%
发文量
24
审稿时长
7 weeks
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