FIELD: medicine.
SUBSTANCE: invention relates to medicine and can be used for cross-core correction of neuromuscular kyphoscoliosis with simultaneous correction of the pelvic obliquity and thoracocervical spine. Transpedicular placement of screws is being performed in the vertebrae C7, Th1, Th2, Th3, Th4 and Th5 on both sides, as well as placement of screws in the vertebrae L2, L3, L4, L5, S1 and in the iliac bones on both sides. First long rod is being modeled in accordance with individual lordosis and kyphosis in the patient's wound with the trajectory of rod modeling according to the form of vertebrae deformation L2, L3, L4, L5, S1 and iliac bone on the right and according to the form of vertebrae deformation C7, Th1 Th2, Th3, Th4 and Th5 – on the left. First modeled long rod is being placed on the vertebrae screws according to the length of the vertebral column deformation from the vertebra L2, L3, L4, L5, S1 and the iliac bone on the right to the vertebrae C7, Th1, Th2, Th3, Th4 and Th5 on the left and a preliminary incomplete tightening of the nuts on the screws of vertebrae is being performed. First modeled long rod is being finally fixed by tightening the nut on the vertebra L2 screw on the right. Segment distraction of vertebrae L3, L4, L5, S1 and iliac bone is being performed, first distraction of vertebra L3 from vertebra L2 is being performed with final fixation of the nut on the vertebra L3 screw, distraction of vertebra L4 from vertebrae L3 is being performed with final fixation of the nut on the vertebra L4 screw, distraction of vertebra L5 from vertebra L4 is being performed with final fixation of the nut on the vertebra L5 screw, distraction of vertebra S1 from vertebra L5 is being performed with final fixation of the nut on the vertebra S1 screw, distraction of the iliac bone S1 with final fixation of the nut on the iliac bone screw, at the same time, a predetermined correction of the pelvic obliquity is provided, the final fixation of the first modeled long rod is performed by tightening the nut on the vertebra Th5 screw on the left, then a segment distraction of the vertebrae C7th, Th1, Th2, Th3, Th4 and Th5, is being performed, first, distraction of the vertebra Th4 from vertebra Th5 with the final fixation of the nut on the vertex Th4 screw, distraction of vertebra Th3 from vertebra Th4 is being performed with the final fixation of the nut on the vertebra Th screw3, distraction of vertebra Th2 from vertebrae Th3 is being performed with final fixation of the nut on the vertebra Th2 screw, distraction of vertebra Th2 from vertebra Th1, is being performed with final fixation of the nut on the vertebra Th1, screw, distraction of vertebra C7 from vertebra Th1 is being performed with the final fixation of the nut on the vertebra C7 screw, while providing a given correction of the thoracocervical spine. Second long fixing rod is being modeled according to the length from vertebra C7 on the right to the iliac bone in the wound of the patient with the trajectory of the bending of the second long fixing rod according to the form of the corrected spine. Second long modeled fixing rod is being placed on the vertebrae screws of the corrected vertebral column from vertebrae L2, L3, L4, L5, S1 and iliac bone on the left to vertebrae C7, Th1, Th2, Th3, Th4 and Th5 on the right and the final fixation of the second long fixing rod on the screws of the vertebrae is being performed by tightening the nuts. After arkotomy, arthrotomy and partial resection of the base of spinous processes and creating posterior spondylodesis with bone grafts with osteomatrix, a transverse fixing metal plate is being placed on both rods at the level of vertebra L1 and rigidly fixed on both rods.
EFFECT: method provides reduced time of surgical intervention and reliable stabilization.
3 cl, 2 ex
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Authors
Dates
2018-03-15—Published
2017-03-10—Filed