Результаты экстирпации полупозвонков комбинированным, дорсальным и педикулярным доступами: систематический обзор

The paper presents a review of 28 domestic and foreign publications with the level of evidence of not less than 2 reporting the treatment results in children with congenital monosegmental anomalies of the spine over the past 15 years. A total of 657 clinical cases were analyzed, including 593 literature cases and 64 cases from authors’ experience. Results of hemivertebra treatment in children using combined approach, extended posterior approach and local posterior approach with transpedicular excision of hemivertebra were analyzed. The following criteria were used for analysis: patient’s age at the time of treatment, magnitude of the local (segmental) curvature before and after surgery, percentage of correction, blood loss volume, duration of surgery, type and length of fixation, and nature and structure of complications. The advantages of transpedicular excision of abnormal vertebra through posterior approach were noted in terms of surgery duration, intraoperative blood loss, risk of neurological complications after comparable correction of deformity, and time required for patient activation and rehabilitation as compared with combined approach, as well as in terms of blood loss volume and correction of kyphotic component as compared with extended posterior approach.