lvrachЛечащий ВрачLechaschi Vrach1560-51752687-118110.26295/OS.2020.24.62.003lvrach-105Research ArticleСтатьиКоррекция деформаций позвоночника у детей и подростков со спинномозговыми грыжамиCorrection of vertebral deformations in children and adolescents with spinal herniasШавыринИ. А.ShavyrinI. A.shailya@ya.ruКолесовС. В.KolesovS. V.noemail@neicon.ruГБУЗ НПЦ СМПД им. В. Ф. Войно-Ясенецкого ДЗМRussian FederationФГБУ НМИЦ ТО им. Н. Н. Приорова Минздрава РоссииRussian Federation202023062021041616Copyright © Шавырин И.А., Колесов С.В., 20212021Шавырин И.А., Колесов С.В.Shavyrin I.A., Kolesov S.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.lvrach.ru/jour/article/view/105

Разработаны оптимальные лечебные мероприятия, направленные на улучшение результатов лечения пациентов с нейромышечными деформациями позвоночника на фоне менингоцеле. 8 пациентам в возрасте от 3 до 17 лет с нейромышечными деформациями позвоночника на фоне менингоцеле было проведено оперативное лечение, выполненное одноэтапно - 5 больных и двухэтапно - 3 больных, 2 пациентам проведена резекция позвоночного столба (VCR). В результате лечения коррекция сколиотической деформации в среднем составила 62%, значение грудного/грудопоясничного кифоза после операции удалось приблизить к физиологическому (40 градусов).

Optimum therapeutic measures aimed at improving the outcomes of patients with neuromuscular spinal deformations against meningocele were developed. Materials and Methods: 8 patients aged 3 to 17 years with neuromuscular spinal deformations against meningocele, surgical treatment was performed one stage — and two-five patients — three patients, two patients underwent resection of the vertebral column (VCR). As a result of correction of scoliosis treatment an average of 62%, the value of thoracic / thoracolumbar kyphosis after surgery could bring to the physiological (40 degrees). 

ГрыжаДетиДорсальная коррекция и фиксация позвоночникаКоллоквиумМенингоцелеНейромышечный сколиозПедиатрияПодросткиРевматологияneuromuscular scoliosismeningoceledorsal spinal correction and fixationReferencesУльрих Э. В. Аномалии позвоночника у детей (руководство для врачей). СПб: Сотис, 1995. 336 с.Ульрих Э. В. Аномалии позвоночника у детей (руководство для врачей). СПб: Сотис, 1995. 336 с.Anderson P. R., Puno M. R., Lovell S. L., Swayze C. R. Postoperative respiratory complications in non-idiopathic scoliosis // Acta Anaesthesiol Scand. 1985; 29: 186-192.Anderson P. R., Puno M. R., Lovell S. L., Swayze C. R. Postoperative respiratory complications in non-idiopathic scoliosis // Acta Anaesthesiol Scand. 1985; 29: 186-192.Banta J. V. Combined anterior and posterior fusion for spinal deformity in Myelomeningocele // Spine. 1990; 15: 946-952.Banta J. V. Combined anterior and posterior fusion for spinal deformity in Myelomeningocele // Spine. 1990; 15: 946-952.Banta J. V., Drummond D. S., Ferguson R. L. The treatment of neuromuscular scoliosis // Instr Course Lect. 1999; 48: 551-561.Banta J. V., Drummond D. S., Ferguson R. L. The treatment of neuromuscular scoliosis // Instr Course Lect. 1999; 48: 551-561.Barsdorf A. I., Sproule D. M., Kaufmann P. Scoliosis surgery in children with neuromuscular disease: findings from the US National Inpatient Sample, 1997 to 2003 // Arch Neurol. 2010, Feb; 67 (2): 231-235.Barsdorf A. I., Sproule D. M., Kaufmann P. Scoliosis surgery in children with neuromuscular disease: findings from the US National Inpatient Sample, 1997 to 2003 // Arch Neurol. 2010, Feb; 67 (2): 231-235.Benson E. R., Thomson J. D., Smith B. G. et al. Results and morbidity in a consecutive series of patients undergoing spinal fusion for neuromuscular scoliosis // Spine. 1998.Benson E. R., Thomson J. D., Smith B. G. et al. Results and morbidity in a consecutive series of patients undergoing spinal fusion for neuromuscular scoliosis // Spine. 1998.Bridwell K. H., DeWald R. L., editors. The textbook of spinal surgery. Philadelphia, PA: Lippincott-Raven, 1997. P. 600-603.Bridwell K. H., DeWald R. L., editors. The textbook of spinal surgery. Philadelphia, PA: Lippincott-Raven, 1997. P. 600-603.Drummond D. S. Neuromuscular scoliosis: recent concepts // J Pediatr Orthop. 1996; 16: 281-283.Drummond D. S. Neuromuscular scoliosis: recent concepts // J Pediatr Orthop. 1996; 16: 281-283.Geiger F., Farsch D., Carstens C. Complications of scoliosis surgery in children with myelomeningocele // Eur Spine J. 1999, 8: 22-26.Geiger F., Farsch D., Carstens C. Complications of scoliosis surgery in children with myelomeningocele // Eur Spine J. 1999, 8: 22-26.Gomez C., Cardoso M., Garavito S. Uso de expansores tisulares en el tratamiento quirurgico de la cifosis en pacientes con mielomeningocele // Acta Ortop Mex. 2008, May-Jun; 22 (3): 162-168.Gomez C., Cardoso M., Garavito S. Uso de expansores tisulares en el tratamiento quirurgico de la cifosis en pacientes con mielomeningocele // Acta Ortop Mex. 2008, May-Jun; 22 (3): 162-168.Hsu J. D. Skeletal changes in children with neuromuscular disorders // Prog Clin Biol Res. 1982; 101: 553-557.Hsu J. D. Skeletal changes in children with neuromuscular disorders // Prog Clin Biol Res. 1982; 101: 553-557.Kinsman S. L., Johnston M. V. Congenital anomalies of the central nervous system. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 592.Kinsman S. L., Johnston M. V. Congenital anomalies of the central nervous system. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 592.Kotwicki T., Durmala J., Czubak J. Bracing for neuromuscular scoliosis: orthosis construction to improve the patient’s function // Disabil Rehabil Assist Technol. 2008, May; 3 (3): 161-169.Kotwicki T., Durmala J., Czubak J. Bracing for neuromuscular scoliosis: orthosis construction to improve the patient’s function // Disabil Rehabil Assist Technol. 2008, May; 3 (3): 161-169.Mackel J. L., Lindseth R. E. Scoliosis and myelodysplasia // J Bone Joint Surg Am. 1975; 57; 1031.Mackel J. L., Lindseth R. E. Scoliosis and myelodysplasia // J Bone Joint Surg Am. 1975; 57; 1031.McCarthy R. E. Management of neuromuscular scoliosis // Orthop Clin North Am. 1999; 30: 435-449.McCarthy R. E. Management of neuromuscular scoliosis // Orthop Clin North Am. 1999; 30: 435-449.Mitchell L. E., Adzick N. S., Melchionne J., Pasquariello P. S., Sutton L. N., Whitehead A. S. Spina bifida // Lancet. 2004: 364: 1885-1895.Mitchell L. E., Adzick N. S., Melchionne J., Pasquariello P. S., Sutton L. N., Whitehead A. S. Spina bifida // Lancet. 2004: 364: 1885-1895.Morillon S., Thumerelle C., Cuisset J. M., Santos C., Matran R., Deschildre A. Effect of thoracic bracing on lung function in children with neuromuscular disease // Ann Readapt Med Phys. 2007 Nov; 50 (8): 645-650.Morillon S., Thumerelle C., Cuisset J. M., Santos C., Matran R., Deschildre A. Effect of thoracic bracing on lung function in children with neuromuscular disease // Ann Readapt Med Phys. 2007 Nov; 50 (8): 645-650.Morrissy R. T. Atlas of pediatric orthopaedic surgery. Philadelphia, PA: IB Lippincott Co, 1992: 181.Morrissy R. T. Atlas of pediatric orthopaedic surgery. Philadelphia, PA: IB Lippincott Co, 1992: 181.Odent T., Arlet V., Ouellet J., Bitan F. Kyphectomy in myelomeningocele with a modified Dunn-McCarthy technique followed by an anterior inlayed strut graft // European Spine Journal. 2004, 13 (3): 206-212.Odent T., Arlet V., Ouellet J., Bitan F. Kyphectomy in myelomeningocele with a modified Dunn-McCarthy technique followed by an anterior inlayed strut graft // European Spine Journal. 2004, 13 (3): 206-212.Osebold W. R., Mayfield J. K., Winter R. B., Moe J. H. Surgical treatment of paralytic scoliosis associated with myelomeningocele // J Bone Joint Surg Am. 1982; 64: 841-852.Osebold W. R., Mayfield J. K., Winter R. B., Moe J. H. Surgical treatment of paralytic scoliosis associated with myelomeningocele // J Bone Joint Surg Am. 1982; 64: 841-852.Phillips J. H., Gutheil J. P., Knapp D. R. Iliac screw fixation in neuromuscular scoliosis // Spine. 2007; 32: 1566-1570.Phillips J. H., Gutheil J. P., Knapp D. R. Iliac screw fixation in neuromuscular scoliosis // Spine. 2007; 32: 1566-1570.Rodgers W. B., Williams M. S., Schwend R. M., Emans J. B. Spinal deformity in myelodysplasia. Correction with posterior pedicle screw instrumentation // Spine. 1997; 22: 2435-2443.Rodgers W. B., Williams M. S., Schwend R. M., Emans J. B. Spinal deformity in myelodysplasia. Correction with posterior pedicle screw instrumentation // Spine. 1997; 22: 2435-2443.Sarwark J., Sarwahi V. New strategies and decision making in the management of neuromuscular scoliosis // Orthop Clin North Am. 2007, Oct; 38 (4): 485-496.Sarwark J., Sarwahi V. New strategies and decision making in the management of neuromuscular scoliosis // Orthop Clin North Am. 2007, Oct; 38 (4): 485-496.Teli M., Elsebaie H., Biant L., Noordeen H. Neuromuscular scoliosis treated by segmental third-generation instrumented spinal fusion // J Spinal Disord Tech. 2005; 18: 430-438.Teli M., Elsebaie H., Biant L., Noordeen H. Neuromuscular scoliosis treated by segmental third-generation instrumented spinal fusion // J Spinal Disord Tech. 2005; 18: 430-438.Vaccaro A. R., Albert T. J. et al. Spine Surgery: Tricks of the Trade. Thieme, New York, Stuttgart. 2009; 321 p.Vaccaro A. R., Albert T. J. et al. Spine Surgery: Tricks of the Trade. Thieme, New York, Stuttgart. 2009; 321 p.

The authors declare that there are no conflicts of interest present.