Experience and technology: St Petersburg University surgeons operate on a girl with severe spinal deformity
Traumatologists-orthopaedists at the Pirogov Clinic of High Medical Technologies at St Petersburg University have performed an operation on the lumbar spine of a child diagnosed with spina bifida. It was a severe congenital disease and the girl spent her whole life lying in bed.
In the process of growth, the little patient’s spine folded almost in half. The vertebrae lay on top of each other to form a kyphotic deformity. The spinal column could not perform its main function. The external means of support or a corset could not help the girl to have a vertical position due to severe deformity and pressure sores.
The operation has been performed by leading traumatologists at the St Petersburg University Clinic. Among them are: Sergei Riabykh and Professor Aleksandr Gubin. They represent the St Petersburg School of Paediatric Spinal Surgery of Professor Eduard Ulrich.
The progression of the disease worsened the general state of health. The deformity caused compression of the chest and abdominal organs. This led to a violation of breathing, digestion and the functioning of all body systems. ‘The presence of a permanent focus of infection and compression of the internal organs was a serious threat to the child’s life. The only way to help was an operation,’ said Sergei Riabykh.
The operation lasted about 10 hours. The doctors removed four vertebrae. The surgeons reassembled the spinal column using titanium rods and screws installed in the thoracic, lumbar, sacral vertebrae, and pelvic bones. During the operation, the doctors managed to straighten the spine. After healing, the girl will be able to sit and take a vertical position by using special devices.
In world practice, such operations are extremely rare. They require the highest qualification of surgeons and the most state-of-the-art equipment in the operating rooms. In complex clinical cases, the probability of screw deviation can reach 20%, according to doctors. To avoid this, the surgeons at the St Petersburg University Clinic used a mobile CT scanner. The mobile CT scanner and a carbon table (therefore "transparent" for X-ray) enabled the doctors to scan the patient’s spine during the operation.
Spina bifida is a defect in the development of the spine and spinal cord that occurs early in the development of the embryo. This pathology is not rare. In Russia, about 0.1-0.2% of the total number of new-borns have such a diagnosis, according to statistics.
The St Petersburg University Clinic have performed operations to correct severe spina bifida deformities for all patients, from infants to the elderly, since 2010. To ensure comprehensive support to children with the consequences of the pathology, a special centre was opened. The centre is headed by Stanislav Ivanov, an orthopaedist-traumatologist.