Paper Information

Journal:   TEHRAN UNIVERSITY MEDICAL JOURNAL (TUMJ)   2004 , Volume 62 , Number 6; Page(s) 462 To 469.
 
Paper: 

RESULTS AND COMPLICATIONS OF SPINAL ARTHRODESIS, OF CONGENITAL DEFORMITIES WITH OR WITHOUT INSTRUMENTATIONS SINA HOSPITAL, 2000- 2002

 
 
Author(s):  RAHJOO A., SADAT M., ZEHTAB M.
 
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Abstract: 

Background: The general aim of this thesis is to report the results and complications of spinal arthrodesis of congenital deformities with or without instrumentations in admitted patients at Sina Hospital, from 2000 to 2002. Details are to report the demographic conditions of patients, time of diagnosis and surgery and duration between these times, complications after and during surgery and diagnosis of associated congenital anomalies.
Materials and Methods: with detection of vertebral anomaly in A.P and lat X-ray of deformed spine patients, the patient is admitted in this thesis. Surgery is indicated in progressive or highly progression potential (line unilateral bar + contra-lateral hemi V) or initially severe deformed curves. The tractional and bending x-ray are obtained after admission of patients. In scoliosis, if the curve is more than 45-50 and less flexible than 5% and in kyphosis, if the curve is more than 50 and patient is more than 5 years old, two stage surgery (ant. release and fusion and post. fusion, with or without instrumentation) were planed, otherwise, post. fusion instrumentation alone was done. Before surgery, screening for detection of genitourinary, cardiovascular and intra-spinal anomalies were done. Minimum follow up after surgery was 6 months. In this period, the patients were evaluated for infection (early, late), neurologic deficits, pseudoarthrosis and device failure and other complications. In the end of 6 months, bone scan was done for pseudo-arthrosis.
Results: From 15 patients, there were 11 female and 4 males. There were 7 scoliosis, 4 kgphscoliosis, 3 kyphosis and 1 thoracic lordosis. The mean time at diagnosis was 5.5 years, at surgery was 14.6 years (interval between these two, was 9 years). Mean time between admissions to discharge was 31 days. Mean time between Ant. And post. Surgery was 13 days and between last surgery to discharge, was 12.9 days. Mean follow up was 13.5 months. In 11 cases, Ant. Release and fusion + P.S.F, in 3 cases, P.S.F alone and in 1 case, vertebral excision were done. Instrumentation was used in 12 cases with correction in 75% of cases. Mean correction were 14.6% in kyphptic, 27% in scoliosis, 28.7% in scoliotic and 25.7% in kyphotic part of kyphoscoliosis. There were two intraspinal (one myelomeningocole and one diastematomyelia) and two genitourinary tract (one left system duplication and one single kidney) anomalies. In one case of kyphoscoliosis, due to hump bedsore klebsiella infection was occurred. In two patients, who were operated with retroperitoneal approach, there were warmness in leg, due to sympatic chain injury.
Conclusion: Early diagnosis and treatment of congenital spine deformities, leads less complications and costs. To approach these goals, we need correct early screening and economic and scientific supports of governmental health organization.

 
Keyword(s): KYPHOSCOLIOSIS, KYPHOSIS, SCOLIOSIS, CONGENITAL, COMPLICATIONS
 
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