Skip to main content
SpringerLink
Log in

Arthrodèses trans-thoraciques dans le traitement des cyphoses et des cyphoscolioses

Transthoracic arthrodesis in the treatment of kyphosis and kyphoscoliosis

  • Published:
International Orthopaedics Aims and scope Submit manuscript

Summary

Since 1965, 116 trans-thoracic spinal fusions have been performed. This study concerns the first 58 procedures on 54 patients followed up for between 2 1/2 and 11 1/2 years.

Surgical management differs according to the following circumstances:

  1. 1.

    Round or angular deformities.

  2. 2.

    Kyphosis or kyphoscoliosis.

  3. 3.

    Degree of correction of the deformity.

  4. 4.

    Spinal cord involvement.

Correction is attempted by distraction cast, halopelvic traction, or Harrington instrumentation by posterior approach. Fusion is performed by thoracotomy or thoracophreno-laparotomy approach. The discs are removed. A cancellous bone graft between the vertebral bodies and strut cortical bone graft may be used separately or combined depending on the pattern of the deformities.

The end results are better when posterior fusion with instrumentation is combined with anterior fusion.

The conclusions concern the prevention of severe deformities and the avoidance of damage to the spinal cord during operation.

Résumé

Entre 1965 et 1976, 116 fusions antérieures trans-thoraciques ont été pratiquées.

Etude des 54 observations ayant un recul de 2 1/2 ans à 11 1/2 ans.

Les problèmes thérapeutiques sont différents selon qu'il s'agit:

  1. 1.

    de cyphoses régulières ou de cyphoses angulaires,

  2. 2.

    de cyphoses ou de cypho-scolioses,

  3. 3.

    de déformations partiellement réductibles ou irréductibles,

  4. 4.

    de déformations provoquant ou non des troubles médullaires.

Les techniques de réduction et de fusion sont étudiées:

  • -plâtre d'élongation, halo, matériel de Harrington;

  • -la fusion par voie trans-thoracique ou par thoracophrénolaparotomie est obtenue par résection des disques et transplants osseux, spongieux ou compacts (éclisse ou étai);

  • -le maintien des résultats est meilleur lorsqu'une ostéosynthèse et une fusion postérieure sont associées au temps antérieur.

Conclusions sur la prévention de ces déformations graves et sur les dangers médullaires de cette chirurgie.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Bibliographie

  1. Anquez, L.: Le traitement neurochirurgical des paralysies cypho-scoliotiques. Acta Orthop. Belg. 33, 568–586 (1967)

    Google Scholar 

  2. Bergoin, M., Sedat, P., Lesbros, A., Mermet, B., Carcassonne, M.: Nouvelle approche thérapeutique dans le redressement chirurgical des cypho-scolioses congénitales de l'enfant. Marseille Chir. 21, 379–386 (1969)

    Google Scholar 

  3. Biot, B.: Les déviations du rachis dans la neurofibromatose de von Recklinghausen. 35 observations du Centre des Massues. Thèse Lyon 1971

  4. Bingold, A. C.: Congenital kyphosis. J. Bone Joint Surg. 35-B, 579–583 (1953)

    Google Scholar 

  5. Dubousset, J., Guillaumat, M., Mechin, J. F.: Cypho-scolioses après laminectomie chez l'enfant. G.E.S. et S.R.S.: Réunion commune: sept. 1973 Lyon, P. Stagnara, ed., pp. 63–67. Lyon 1973

  6. Du Peloux, J., Fauchet, R., Faucon, B., Stagnara, P.: Le plan d'élection pour l'examen radiologique des cypho-scolioses. Rev. Chir. Orthop. 51, 517–524 (1965)

    Google Scholar 

  7. Duval-Beaupère, G., Dubousset, J.: La dislocation rotatoire progressive du rachis. Rev. Chir. Orthop., 58, 323–334 (1972)

    Google Scholar 

  8. Hall, J. E.: The anterior approach to spinal deformities. Orthop. Clin. North Am. 3, 81–98 (1972)

    Google Scholar 

  9. Hall, J. E.: The place of the anterior approach to the spine in scoliosis surgery. Post-graduate course on the management and care of the scoliosis patients New-York Orthopaedic Hospital Nov. 5, 7, 32–34, 1970

  10. Harrington, P. R., Dickson, J. H.: An eleven year clinical investigastion of Harrington instrumentation. A preliminary report of 578 cases. Clin. Orthop. 93, 113 (1973)

    Google Scholar 

  11. Hodgson, A. D.: Correction for fixed spinal curves. A preliminary communication. J. Bone Joint Surg. 47-A, 1221–1227 (1965)

    Google Scholar 

  12. James, J. I. P.: Kyphoscoliosis. J. Bone Joint Surg. 37-B, 414–426 (1955)

    Google Scholar 

  13. Johnson, J. T. H., Robinson, R. A.: Anterior strut graft for severe kyphosis. Result of three cases with a preceding progressive paraplegia. Clin. Orthop. 56, 25–36 (1968)

    Google Scholar 

  14. Leatherman, K. D.: Neurological problems in kyphosis and scoliosis. News notes. Scoliosis Research Society. J. Bone Joint Surg. 53-A, 197 (1971)

    Google Scholar 

  15. Leatherman, K. D. The management of rigid spinal curves. Clin. Orthop. 93, 215–224 (1973)

    Google Scholar 

  16. Marpeau, M., Lacert, Ph., Grossiord, A., Duval-Beaupere, G.: A propos de 6 cas de cyphoses ou cypho-scolioses congénitales compliquées de troubles neurologiques. Ann. Méd. Phys. 18, 117–135 (1974)

    Google Scholar 

  17. Mener, G.: Les scolioses combinées essentielles. Etude de 60 dossiers. Thèse Rennes 1975

  18. Nickel, V. L., Perry, J., Garret, A., Heppenstall, M.: The halo. J. Bone Joint Surg. 50-A, 1400–1409 (1968)

    Google Scholar 

  19. O'Brien, J. P., Yau, A.C.M.C., Smith, T. K., Hodgson, A. R.: Halo pelvic traction. J. Bone Joint Surg. 53-B, 217–229 (1971)

    Google Scholar 

  20. Riseborough, E, J.: The anterior approach to the spine for the correction of deformities of the axial skeleton. Clin. Orthop. 93, 207–214 (1973)

    Google Scholar 

  21. Schneider, R. C.: Transposition of the compressed spinal cord in kyphoscoliotic patients with neurological deficit. With special reference to the vascular supply of the cord. J. Bone Joint Surg. 42-A, 1027–1039 (1960)

    Google Scholar 

  22. Stagnara, P.: Les déformations sagittales. Dans: Radiodiagnostic, pp. 31–131 C10, 31–131 E10. Paris: Encyclopédie médicochirurgicale 1971

    Google Scholar 

  23. Stagnara, P.: Déviations et déformations sagittales du rachis. Dans: Appareil locomoteur, p. 15865 E10. Paris: Encyclopédie médico-chirurgicale 1976

    Google Scholar 

  24. Stagnara, P.: Traction crânienne par le halo de Rancho Los Amigos. Rev. Chir. Orthop. 57, 287–300 (1971)

    Google Scholar 

  25. Stagnara, P., Du Peloux, J., Fauchet, R., Bouillat, G., Mazoyer, D., Callay, C.: A propos de 17 observations de paraplégies par déformations vertébrales traitées par redressement partiel. Rev. Chir. Orthop. 54, 623–636 (1968)

    Google Scholar 

  26. Stagnara, P., Gounot, J., Fauchet, R., Jouvinroux, P.: Les greffes antérieures par voie thoracique dans le traitement des déformations et des dislocations vertébrales en cyphose et cypho-scoliose. Rev. Chir. Orthop. 60, 39–56 (1974)

    Google Scholar 

  27. Stagnara, P., Perdriolle, R.: Elongation vertébrale continue par plâtres à tendeurs. Possibilités thérapeutiques. Rev. Chir. Orthop. 44, 57–74 (1958)

    Google Scholar 

  28. Vauzeile, C., Stagnara, P., Jouvinroux, P.: Functional monitoring of spinal cord activity during spinal surgery. Clin. Orthop. 93, 173–178 (1973)

    Google Scholar 

  29. Villard, B.: Les arthrodèses vertébrales antérieures par voie thoracique pour le maintien des réductions des cyphoses et des cypho-scolioses. (A propos de 54 observations du Centre des Massues). Thèse Lyon 1975

  30. Winter, R. B., Moe, J. H., Wang, J. F.: Congenital kyphosis. J. Bone Joint Surg. 55-A, 223–256 (1973)

    Google Scholar 

  31. Bradford, D. S., Moe, J. H., Montalvo, F. J., Winter, R. B.: Scheuermann's kyphosis and roundback deformity. J. Bone Joint Surg. 56-A, 740–758 (1974)

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Centre de Réadaptation Fonctionnelle des Massues, 92, rue E. Locard, F-69322, Lyon Cedex 1, France

    P. Stagnara, J. Gounod, A. Campo-Paysaa, C. Vauzelle, R. Fauchet, D. Mazoyer, B. Biot, C. Poncet, J. C. de Mauroy & B. Villard

Authors
  1. P. Stagnara
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. Gounod
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Campo-Paysaa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. Vauzelle
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. R. Fauchet
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. D. Mazoyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. B. Biot
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. C. Poncet
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. J. C. de Mauroy
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. B. Villard
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Transthoracic Arthrodesis in the Treatment of Kyphosis and Kyphoscoliosis

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stagnara, P., Gounod, J., Campo-Paysaa, A. et al. Arthrodèses trans-thoraciques dans le traitement des cyphoses et des cyphoscolioses. International Orthopaedics 1, 199–214 (1977). https://doi.org/10.1007/BF00266338

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00266338

Key words

Search

Navigation