THORACIC AND LUMBAR HEMIVERTEBRA EXCISION IN PEDIATRIC PATIENTS: HOW DOES THE OPERATION TECHNIQUE INFLUENCE ON OUTCOMES? (СOHORT ANALYSIS AND LITERATURE REVIEW)

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Abstract

Purpose of the study — to study impact of hemi-vertebrae extirpation technique in mono-segmental reconstruction on the surgical trauma.

Material and Methods. 34 patients underwent 36 mono-segmental extirpations of hemi-vertebrae followed by a posterior fixation during a single center four years cohort study. Mean age of children at the moment of procedure was 4 years and 3 months (min — 1 year, max — 14 years). The authors studied impact of pathology level, surgical approach, type of bony structures removal technique and age of the patients on the time of procedure and volume of blood loss.

 Results. Extirpation of thoracic hemi-vertebrae was characterized by a lengthier procedure and greater blood loss in contrast to lumbar hemi-vertebrae. Patients were divided into three groups depending on extirpation technique: 1)  extirpation from two approaches using a high-speed burr; 2) from a single dorsal approach using the same extirpation technique; 3) from dorsal approach using ultrasonic bone scalpel. Surgery time was 208±72 min in the first group, 187±54 min in the second group, and 170±30 min in the third group; blood loss volume was 181±39, 181±53, 132±73 ml respectively in the groups, or 11.5±4.3%, 9.4±2.8% and 9.6±5.2% of total blood volume, respectively.

Conclusion. Surgical approach and hemi-vertebrae extirpation technique in children have a varying impact on surgery time and intraoperative blood loss, and the least values were reported for posterior approach using ultrasonic bone scalpel.

About the authors

A. Yu. Mushkin

Saint-Petersburg State Research Institute of Phthisiopulmonology; Mechnikov North-Western State Medical University.

Author for correspondence.
Email: fake@neicon.ru

 Alexander Yu. Mushkin — Dr. Sci. (Med.), professor, Chief researcher, Head of Clinic of Pediatric Surgery and Orthopaedics.

2-4, Ligovsky pr., 191036, St. Petersburg; 41, Kirochnaya ul., 191015, St. Petersburg.

Russian Federation

D. G. Naumov

Saint-Petersburg State Research Institute of Phthisiopulmonology.

Email: fake@neicon.ru

Denis G. Naumov — resident physician.

2-4, Ligovsky pr., 191036, St. Petersburg.

Russian Federation

E. Yu. Umenushkina

Saint-Petersburg State Research Institute of Phthisiopulmonology.

Email: fake@neicon.ru

Ekaterina Yu. Umenushkina — anesthesiologist.

2-4, Ligovsky pr., 191036, St. Petersburg.

Russian Federation

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