METHOD FOR SURGICAL CORRECTION OF PELVIC TILT IN CHILDREN WITH NEURO-MUSCULAR AND SYNDROMAL SCOLIOSE Russian patent published in 2023 - IPC A61B17/70 

FIELD: traumatology; orthopedics; neurosurgery.

SUBSTANCE: used to correct the spatial orientation of the pelvis in children with neuromuscular and syndromic scoliosis. Access is made to the posterior elements of the spine up to the articular processes. Transpedicular screws are inserted into the vertebral bodies under the control of the Stealth Station navigation system, for which screws are installed transpedicularly on the right and left at the levels of the planned metal fixation. Polyaxial screws are passed through the posterior superior iliac spine into the iliac bones towards the greater sciatic notch on both sides. At L3-L4-L5-S1 levels, facetectomy is performed using an ultrasonic bone scalpel Misonix, for which a pre-curved rod is placed on the screws in the thoracolumbar spine on the right and left to match the spinal deformity and secured with nuts. Correction of scoliotic deformity is performed using a derotational maneuver, forming kyphosis and lordosis. Under the control of a visualization system to confirm the stability of the O-arm fixation in 2-D mode, the final fixation of the supporting elements to the rod with nuts is performed. At the level of the L4 vertebra, connectors are fixed to the rod laterally on each side, interconnected end to side, due to the presence of polyaxial heads at the ends, and the position of the pelvis in space is manipulated in all three planes. The distal ends of the connectors are fixed into the heads of polyaxial screws inserted into the iliac bones, segmental contraction and distraction are performed between the connectors, achieving correction of the pelvic tilt. The final tightening and fixation of the connectors is carried out. Decortication of the posterior elements of the spine is carried out; the auto-bone obtained during the formation of transpedicular canals is fragmented, supplemented with an allograft based on hydroxyapatite and laid along the elements of the metal structure, forming a posterior spinal fusion. A vacuum drainage system for the wound is installed through the counter-aperture, the wound is sutured in layers and an aseptic bandage is applied.

EFFECT: method provides multi-planar correction of pelvic tilt and allows for independent correction of deformation of the thoracolumbar spine and spatial orientation of the pelvis through the use of two pairs of open lateral connectors on each side, which makes it possible to achieve stability of the spinopelvic fixation, eliminating the need to stabilize the anterior column of the spine.

1 cl, 6 dwg, 1 ex