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2011, Number 2

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Ortho-tips 2011; 7 (2)

Corrección quirúrgica (principios generales y métodos)

Dittmar JM
Full text How to cite this article

Language: Spanish
References: 10
Page: 102-107
PDF size: 119.99 Kb.


Key words:

Scoliosis, deformity, balance, desrotation, osteotomy.

ABSTRACT

Scoliosis is a deformity in three planes. The principles to compensate for these forces must be understood to act and achieve surgical correction of the deformity without altering the balance of the person either in the frontal plane as in the very important sagittal plane. The sagittal balance is the plumb line coming from the front of the body of C7 to the anterior border of the sacrum, with a tolerance of ± 2 cm. To achieve the correction of scoliosis, various devices are needed, with different levels of correction: Wire. It has great grip, but little or no control over compression or distraction forces. Hooks. Only take the posterior elements of the vertebral body, but they can make corrections in compression and distraction, depending on the anchor site. Screws. Can be placed through the pedicles to the vertebral body, and achieve the best correction in any plane of motion (compression, distraction, translation and desrotation). To correct the deformity of scoliosis, you should use different maneuvers: Compression. For closure and shortening should be used on the convex side of the curve, and in the back plane can achieve lordosis curves. Distraction. It helps to derotate the vertebral column, but it must be done carefully to avoid any neurological damage. Desrotation and translation. They are used to correct the rotation and translation of scoliosis. You can use other complementary maneuvers to correct scoliosis, described briefly in this article.


REFERENCES

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  2. White AA, Panjabi MM. Clinical biomechanics of the spine. 2nd Ed., 1990, ISBN 0-397-50720-8.

  3. Chen PQ, Yen LJ. A 8 to 13-year follow-up of Cotrel-Dubousset instrumentation for the correction of King II and III adolescent idiopathic scoliosis. In: 21st Annual combined meeting of the ASEAN and IOA, Bali, 2001.

  4. Mota BR. Congreso Sociedad Mexicana de Ortopedia, México, 1991.

  5. Webb JK, Burwell RG, Cole AA, et al. Posterior instrumentation in scoliosis. Eur Spine J 1995; 4: 2-5.

  6. Lenke LG, Betz RR, Haher TR, et al. Multisurgeon assessment of surgical decision-making in adolescent idiopathic scoliosis: curve classification, operative approach, and fusion levels. Spine (Phila Pa 1976) 2001; 26(21): 2347-2353.

  7. Smith-Petersen MN, Larson CB, Aufranc OE. Osteotomy of the spine for correction of flexion deformity in rheumatoid arthritis. Clin Orthop Relat Res 1969; 66: 6-9.

  8. Thomasen E. Vertebral osteotomy for correction of kyphosis in ankylosing spondylitis. Clin Orthop Relat Res 1985; (194):142-152.

  9. Bradford DS. Vertebral column resection. Orthop Trans 1987; 11: 502.

  10. Cotrel Y, Dubousset J. A new technique for segmental spinal osteosynthesis using the posterior approach. Rev Chir Orthop Reparatrice Appar Mot 1984; 70(6): 489-494.




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Ortho-tips. 2011;7