Assuntos
Fenda Labial/diagnóstico , Fenda Labial/cirurgia , Fissura Palatina/diagnóstico , Fissura Palatina/cirurgia , Anormalidades do Olho/diagnóstico , Anormalidades do Olho/cirurgia , Dedos/anormalidades , Recém-Nascido Prematuro , Articulação do Joelho/anormalidades , Deformidades Congênitas das Extremidades Inferiores/diagnóstico , Deformidades Congênitas das Extremidades Inferiores/cirurgia , Sindactilia/diagnóstico , Sindactilia/cirurgia , Anormalidades Urogenitais/diagnóstico , Anormalidades Urogenitais/cirurgia , Tomada de Decisão Clínica , Gerenciamento Clínico , Dedos/cirurgia , Humanos , Recém-Nascido , Articulação do Joelho/cirurgia , Resultado do TratamentoRESUMO
PURPOSE: The purpose of this study is to present a large consecutive series of pediatric patients affected by neuromuscular scoliosis treated with Unit Rod instrumentation. METHODS: Retrospective review of 160 children treated with Unit Rod instrumentation between 2003 and 2010. This review analyzed complications, radiographic outcome, time surgery, average blood loss, hospital staying and functional outcome of patients and parents after surgery. The follow-up of 80 patients is at more than 5 years. RESULTS: Scoliosis was corrected from a mean of 56° range 21° to 76° Cobb (68 %). Pelvic obliquity was corrected from a mean of 24° to 5° (74 %). Major complications are not related to the technique but to the pathology. CONCLUSION: Unit Rod instrumentation is a common standard technique, is considerably less expensive than the other system, and remains a good indication for the treatment of the spinal deformity in children affected by neuromuscular disease.
Assuntos
Fixadores Internos , Doenças Neuromusculares/patologia , Escoliose/patologia , Escoliose/cirurgia , Fusão Vertebral/instrumentação , Fusão Vertebral/métodos , Adolescente , Criança , Feminino , Humanos , Tempo de Internação , Masculino , Estudos Retrospectivos , Resultado do Tratamento , Adulto JovemRESUMO
In this article, we analysed the orthopaedic malformation in patients affected by Chiari I malformations as well as conservative or surgical treatment. The most common deformity in these patients is scoliosis. Different studies suggest a causal relation between syringomyelia and spinal deformities that differ by the type of deformities: asymptomatic scoliosis is characterized by a higher incidence of a single curve and convexity to the left, while symptomatic scoliosis is characterized by a double thoracolumbar curve. The conservative treatment with brace in these patients is not effective and scoliosis is typically evolutive. The evidence of the international data is that in patients without myelomeningocele or congenital scoliosis, but with Arnold Chiari I malformation and syringomyelia, suboccipital craniectomy gives the best chance for syrinx reduction and scoliosis improvement, particulary in children younger than 10 years and below a Cobb angle of 30°. The orthopaedic treatment in late decompression or in progressive curve is spine arthrodesis.
