Osteosynthesis in children and teenagers with traumatic spine deformations

Abstract

Work’s goal: Rising of treatment’s efficiency at traumatic deformations of thoracal and lumbar spine department at children by means of development differentiated surgical tactics. Material and methods. 29 patients with spine deformations have been pre- and postoperatively examined. The evaluation included collecting of anamnesis data, clinical examination, labs and imaging (standard radiography/ with functional tests, magnetic resonance) with a follow-up of 1 to 5 years. Children were aged between 3 and 17 years. The indications to operative treatment were: spine instability (on F.Denis’ scale) at which there are damages of two or more backbone’s colons, according to AO/ASIF classification (Gertzbein S.D., 1994): Types AI – 3 (10,3%) patients, AII-AIII – 14 (48,3%), BI-BIII – 7 (24,1%), CII-CIII – 5 (17,2%) patients. Results. The main goals of surgical interventions were: elimination of the compression factor, deformation and disbalance, correction and spine stabilization. The comparative analysis of the quality of life of patients (according to a questionnaire „EQ-5D”), before and after surgical intervention, has shown that the quality of life of patients improved, in comparison with the preoperative period, from 12,7±0,3 points to 7,7±0,1. Conclusions. 1. In fresh cases of the complicated spinal - marrow trauma with mild and average degree of a neurologic symptomatology (degree of D on Frenkel) the preference was given to the closed, indirect decompression. At a serious neurologic symptomatology (A, B, C degree) carried out open decompression and revision of dural bag’s contents. 2. The early surgical intervention leads to pain syndrome’s cupping, restoration of a vertebral form, elimination of the spine deformation and stabilization of the damaged segment, using only back access.