Affiliation:
1. JSC “Medicine”
2. JSC “Medicine”;
Pirogov Russian National Research Medical University
3. Pirogov Russian National Research Medical University
4. Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center
Abstract
In this review are discussed the most important questions of diagnostics, surgical treatment and complications in the context of anaesthesia choice and performance in children and adolescents with different variants of vertebral scoliotic deformity. Vertebral scoliotic deformity is a multi-etiological disease and significant clinical problem due to frequency and severity of complications when disease progresses. Surgery is performed in severe and super severe scoliotic deformity when conservative treatment is not effective. Surgical treatment of severe scoliotic deformity allows to improve physiological function of vertebral column and internal organs’ function, improve quality of life and increase life expectancy. Surgical treatment of severe scoliotic deformity is one of the most complex problem in traumatology and orthopedics which requires multidisciplinary coordination of surgeon, anesthesiologist, narrow specialists and the patient at every step of treatment. The most significant problems in surgical treatment of severe scoliotic deformity are forecasting and blood loss management during the operation and in post-operative care which could reach several circulating blood volumes. The problems of blood loss minimization are discussed: patient’s position on operating table, acute normovolemic haemodilution, managed hypotension, use of antifibrinolythic medications, blood collection and re-infusion, blood transfusion. Blood loss forecasting is an important instrument to get a proactive information to develop personalized approach to patient’s care with assessment of intraoperative blood loss, risk of hemorrhagic shock and disseminated intravascular coagulation syndrome.
Reference25 articles.
1. Takeuchi R., Mutsuzaki H., Mataki Y., Kamada H. Progressive age and other factors affecting scoliosis severity in cerebral palsy patients. J Rural Med. 2020;15(4):164–169. https://doi.org/10.2185/jrm.2020-013.
2. Ryabykh S.O., Savin D.M., Medvedeva S.N., Gubina E.B. The experience in treatment of the spine neurogenic deformities. Genij Ortopedii 2013;(1):87–92. (In Russ.) Available at: https://ilizarov-journal.com/index.php/genius/article/view/2168.
3. Youssef J.A., Orndorff D.O., Patty C.A., Scott M.A., Price H.L., Hamlin L.F. et al. Current status of adult spinal deformity. Global Spine J. 2013;3(1): 51–62. https://doi.org/10.1055/s-0032-1326950.
4. Schwab F.J., Smith V.A., Biserni M., Gamez L., Farcy J.P., Pagala M. Adult scoliosis: a quantitative radiographic and clinical analysis. Spine (Phila Pa 1976). 2002;27(4):387–392. https://doi.org/10.1097/00007632-200202150-00012.
5. Sadovaya T.N., Tsytsorina I.A. Screening of spinal deformations in children as component of population health protection. Polytrauma. 2011;(3): 23–28. (In Russ.) Available at: https://poly-trauma.ru/index.php/pt/issue/viewIssue/23/21.