RESUMO
To assess the effectiveness of deformity correction and safety of the two major corrective spinal surgical procedures, 35 patients, aged 14-47 years, were placed into two groups according to procedures performed. Sixteen patients (group A) had four-stage procedures including initial halo-pelvic distraction after anterior release and a subsequent three procedural steps plus brace. Nineteen patients (group B) had one-set two-stage procedures: wire segmental stabilisation in eight cases and rod/hook and/or pedicle screw stabilisation in 11 cases. Average preoperative kyphosis in group A was 88° and postoperative at zero, three, six, and 18 months were 29Ë, 33Ë, 35Ë and 35Ë, respectively, while those of group B were 86Ë preoperative and postoperative 27Ë, 31Ë, 33Ë, and 33Ë, respectively. Neural complication developed in five cases: one in group A and four in group B. It was concluded that the one-set two-stage procedure is more efficient, time-saving, and cost-effective, though it is highly challenging with relatively high rates of neural complication.
Assuntos
Cifose/cirurgia , Procedimentos Ortopédicos/métodos , Tuberculose Osteoarticular/cirurgia , Adolescente , Adulto , Parafusos Ósseos , Fios Ortopédicos , Braquetes , Análise Custo-Benefício , Humanos , Cifose/diagnóstico por imagem , Pessoa de Meia-Idade , Procedimentos Ortopédicos/economia , Procedimentos Ortopédicos/instrumentação , Radiografia , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Tuberculose Osteoarticular/diagnóstico por imagem , Adulto JovemRESUMO
PURPOSE: To evaluate the morphologies of congenital C2-3 synostosis in 25 patients. METHODS: Radiographs of 11 males and 14 females aged 5 to 74 years with congenital C2-3 synostosis were reviewed. All cases were found incidentally on radiographs when presenting with neck/shoulder discomfort/pain. RESULTS: 13 of the patients had spondylosis in 21 segments: C1-2 (n=1) and C3-4 (n=1), C4-5 (n=7), C5-6 (n=9), and C6-7 (n=3). Of whom 12 had normal sagittal alignment and one had kyphotic synostosis (who developed compensatory hyperlordosis of the caudal mobile segments and subsequent spondylosis at C3-4 and C5 retrolisthesis). The remaining 12 patients had no spondylosis and had normal sagittal alignment, but had other associated pathologies including disc herniation at C3-4, C1 ring hypoplasia, and calcification of the nuchal ligament. CONCLUSION: Normally aligned congenital synostosis of C2-3 is rarely associated with a junctional problem, whereas a kyphotic synostosis is associated with a caudal junctional problem. Spondylosis developing after age 40 years is not associated with C2-3 synostosis.