MISTAKES IN DIAGNOSIS AND SURGICAL TREATMENT OF CHILDREN WITH INJURIES OF THE SPINE AND SPINAL CORD

Abstract

Objective. To analyze mistakes in diagnosis and tactics of surgical treatment of children with the spine and spinal cord injuries. Material and Methods. A retrospective analysis of treatment outcomes in 237 children aged 3 to 17 years with the spine and spinal cord injuries was carried out. Out of them 54 patients (23.0 %) had vertebral fractures complicated by neurological disorders, 183 (77.0 %) had unstable injuries. Mistakes made on stages of diagnosis and surgical treatment were evaluated. Results. It was found that children with unstable spinal injuries misdiagnosed as compression vertebral fractures were treated conservatively in 26 cases (11.0 %). Laminectomy without instrumented stabilization, which resulted in the progression of posttraumatic kyphosis was performed in 9 cases (3.8 %). Incorrect placement of pedicle screws, which required reoperation, was detected in 6 patients (2.5 %). Application of anterior instrumentation caused development and progression of spinal kyphosis in 3 cases (1.3 %). Posterior reduction and instrumented stabilization without timely reconstruction of the anterior and middle columns of the fractured vertebral bodies in the growing spine were revealed in 3 children (1.3 %). Conclusion. Mistakes in diagnosis and surgical treatment of children with the spine and spinal cord injuries resulted in repeated surgeries and sometimes in irreversible consequences.