THEO DÕI LÂU DÀI HIỆU QUẢ PHẪU THUẬT NẮN CHỈNH, CỐ ĐỊNH VẸO CỘT SỐNG TẠI ĐƠN VỊ CỘT SỐNG BỆNH VIỆN TRƯNG VƯƠNG - TPHCM Hồ Nhựt Tâm1, Huỳnh Chí Hùng2, Huỳnh Minh Tâm1, Phan Thanh Trọng1, Võ Văn Thành2

Abstract

Background: Scoliosis is a spinal deformity with lateral rotating curve on coronal plane; this condition is often accompanied by hypokyphosis or hyperkyphosis. Scoliosis is most common in adolescent patients. In addition to aesthetic issues that affect the psychology of patients, affect learning or marriage, daily activities; scoliosis mainly affects the respiratory and cardiovascular systems, as scoliosis progresses more and more with the development of the skeleton, especially during puberty. Surgical indication is strictly dedicated to severe scoliotic patients. Objectives: This purpose of this study is to assess the results of Scoliosis Surgery of the Spine Unit, Trung Vuong hospital since 2017. Method: Retrospective, case-series study. Results: Surgical method: Posterior correctionfixation: 32 cases (94%), two-stage anterior releasing and posterior correction-fixation with double rods system: 1 case, two-stage anterior releasing and posterior correction-fixation with triple rods system: 1 case. Patients data: Gender: Female: 26 cases, Male: 8 cases. Average age: 17.6 y.o. Etiologies include Idiopathic: 14 cases, syndrome 14 cases, Congenital 5 cases, Scar constricture 1 case. Severity: Severe scoliosis (40-60º): 14 cases and very severe scoliosis (>60º): 20 cases. Classification: Main Thoracic Scoliosis 24 cases and Main Lumbar Scoliosis 10 cases. The mean follow-up: 12.4 months. Average postop correction rate: 66.5%. Post-op height increase: +2.7 cm. Loss correction follow-up: 0.3º. Complications: Hemothorax: 1 case, partial paraplegia due to medially inserted displacement of right L1:1 case, revision surgery to correct shoulder balance: 1 case, removing surgery of T10 screw penetrated the anterior body cortex with its tip close to the aorta: 1 case. Conclusion: Preoperative assessment of scoliosis is very important for choosing the appropriate surgical method as well as the appropriate pedicle construction for scoliosis correction. Posterior correction-fixation surgery with whole pedicle screws construct and precise entry point offer good stability, with little change after long-term follow-up. The modified natural anatomical technique to insert pedicle screws allows freehand without the use of C-arm reduces the complications.