Nhân một trường hợp điều trị vẹo cột sống nặng thì một đặt dụng cụ kéo Halo và thì hai nắn chỉnh, hàn xương

The management of severe spinal deformities, particularly kyphoscoliosis, has long presented significant surgical challenges. Historically, single-stage correction and fusion surgeries preceded by prolonged Halo traction were associated with extended operative times and a higher incidence of perioperative complications, posing considerable hurdles for surgical teams and anesthesiologists. This context has driven the exploration of alternative treatment modalities. Consequently, a two-stage surgical approach, involving posterior spinal release followed by Halo traction and then a subsequent correction and fusion, has emerged as a promising method to mitigate these risks and improve patient outcomes. This case report aims to evaluate the efficacy and safety of this two-stage surgical strategy for severe kyphoscoliosis through a detailed clinical case and a review of relevant literature.

Orthopedic surgeons, neurosurgeons, anesthesiologists, and researchers specializing in spinal deformities and their surgical management.

This paper presents a detailed case report on the successful application of a two-stage surgical treatment for a 14-year-old female patient diagnosed with severe double curve scoliosis and Von Recklinghausen syndrome. Addressing the complexities of severe kyphoscoliosis, the innovative approach involved an initial posterior spinal release with pedicle screw insertion, followed by a 17-day period of continuous Halo traction. The second stage then proceeded with a posterior column osteotomy, definitive correction, and spinal fusion using bone grafts. Patient data, meticulously collected preoperatively, perioperatively, and postoperatively, demonstrated encouraging clinical and radiological improvements. Notably, intraoperative neurophysiological monitoring remained stable throughout both surgical stages, underscoring the safety profile of the procedure. While previous single-stage treatments were often associated with higher complications and burdens on medical staff, this two-stage method appears to distribute the surgical load, potentially reducing the risk of complications and enhancing the overall well-being of the patient. The initial results indicate this method offers a promising alternative with favorable outcomes and minimal complications. However, the study emphasizes the critical need for long-term follow-up to comprehensively assess the sustained efficacy and potential late-onset issues of this treatment for scoliosis.