But the child is smiling—clinical treatment of congenital spinal deformity in children
"Plums remain sour and soft, and plantains are divided into green and window screens. When they grow up, they wake up relentlessly and watch children catch willow flowers." The leisurely feelings of early summer became more vivid and interesting because of the childish children entering the painting. But not all children are born healthy, and some children unfortunately suffer from spinal deformity, and the quality of life is severely affected. In addition, it also brings pain and burden to the family.
The classification of spinal deformity in children mainly includes: congenital spinal deformity, idiopathic spinal deformity and neuromuscular spinal deformity. If the patient cannot be treated well in the early stage, with the exacerbation of the disease, the chest and ribs will often be deformed, and the development of the chest and lungs will be affected, which will affect their quality of life and long-term prognosis.
This article will focus on the clinical treatment of congenital scoliosis. Congenital scoliosis begins when the spine develops before birth, when one or more spine structures are not fully formed, or the spine does not have normal segments. Severe and progressive congenital kyphosis deformities, exceeding 45 degrees or kyphosis with neurological impairment or even muscle weakness, often require surgery. Early surgical intervention can often achieve the best results and prevent the progression of kyphosis. The specific method of surgery should be selected according to the specific conditions of the deformity.
Hemivertebral deformity is the main common cause of congenital scoliosis, and it is reported in the literature that it accounts for 46% of congenital scoliosis, which is one of the poor vertebral formations. Hemivertebrae can cause spinal deformities and continue to progress, and their speed depends mainly on the characteristics of the deformities. An effective orthopedic effect can be achieved by posterior hemivertebral resection. Professor Zhang Xuejun's team at Beijing Children's Hospital conducted a series of studies on the treatment of congenital scoliosis in children with posterior hemivertebral resection short segment fixation and growth rod technology. Hemivertebral resection and short segment fixation studies show that for children with multiple hemivertebral deformities at the age of 3-7 years, short segment fixation and fusion can be achieved by resection of coronary or sagittal deformity hemivertebrae. The good orthopedic effect has little effect on the growth of the thoracic spine and spine, which effectively ensures the overall balance and growth potential of the spine. As far as the growth rod technique is concerned, appropriate orthopedic methods can be used in combination with different arrangements of the coronal plane to obtain satisfactory coronal plane balance and clinical efficacy.
《 应用生长棒技术治疗小儿先天性脊柱侧凸对椎体生长发育的影响》） (Literature sharing: " Effects of the application of growth rod technology on congenital scoliosis in children on vertebral growth and development")
In children, especially infants and young children, the design of internal fixation often has an important impact. If you use products that are not specific to the bone characteristics of young children, there are often the following adverse consequences:
1. The product notch is too high, causing soft tissue irritation, and even local ulcer or infection after operation.
2. No special diameter is suitable for pedicle diameter of children with hypoplasia. Excessive screw diameter causes destruction of the pedicle.
3. The plug torque is too high, and the bone is damaged when tightened.
4. No special osteotomy or de-rotation kit.
In addition to his extensive experience in clinical treatment, Professor Zhang Xuejun's team has also been committed to the design and development of a special system for the treatment of spinal deformity in children. The Adena4.5 system jointly developed by him and Shanghai Sanyou Tuoteng Laboratory has been put into clinical use for 3 years. The screw in the implant has the characteristics of low notch and high strength fixing. Compared with similar products, the size of the screw tail rod is significantly better than other competitive products. For Chinese children, especially thin children It can greatly avoid complications such as local ulcers and infections caused by soft tissue stimulation and compression. At the same time, the product is equipped with two kinds of locking mechanisms, self-breaking nut and non-self-breaking nut, which are suitable for different bones and avoid pedicle damage caused by excessive locking force.
In addition, Professor Zhang Xuejun's team also conducted research and analysis on conservative treatment of congenital scoliosis. Studies have shown that both congenital scoliosis and non-congenital scoliosis can control scoliosis and slow its progress to a certain extent in a series of plaster correction treatments, while maintaining normal spinal growth. However, despite the fact that all patients prolonged the first operation for an average of 18 months, the progression of malformations in 5 patients with idiopathic scoliosis was still under control. But researchers still believe that most patients still need surgery, especially those with congenital scoliosis. The main effect of serial plaster correction is to delay the operation time, and its long-term effect requires further follow-up observation. Considering that the number of gypsum correction methods is far lower than the complication rate of surgical treatment, the researchers believe that it is an effective choice in the treatment of early-onset scoliosis in young age.
系列Mehta石膏矫正先天性脊柱侧弯：早期治疗的有效方法》） (Literature sharing: " Mehta series correction of congenital scoliosis: an effective method for early treatment")
Children's Day is a happy holiday. Scholars who are dedicated to children's spinal deformity orthopedics use their research and practice to bring new hope and future for each family. I hope that every child can have a straight back and greet a beautiful life. .