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Algorithm for choosing the tactics of treating patients with congenital spinal deformities

Abstract

When conducting statistical studies in the Republic of Belarus, it was noted that congenital malformations of the spine account for 2.5–7% of all identified cases. At the same time, in half of the cases there is a progressive development of the vertebral curvature, where active corrective treatment is necessary.  However, the emphasis on radiation diagnostics, as the only method for diagnosing the aggressiveness of the course of the disease, often lags behind the intensity of clinical manifestations.

AIM  OF THE STUDY:  development of criteria for early surgical intervention in the presence of severe congenital spinal deformities in children.

MATERIALS AND  METHODS. The studies were carried out in 52 patients with congenital spinal deformities. The radiation method of research was carried out in 52 patients, the microelement composition of blood (Zn, P, Ca, Cu), and the content of Se, Ag, Pb, Cd were also studied. As part of a genetic study, polymorphisms of the detoxification genes GSTT1, GSTM, GSTP1 (lle105Val), GSTP1 (Ala114Val), as well as mutations of the genes responsible for the growth rate and structure of the vertebrae and intervertebral discs — the  HOXA11, HOXD 13, RUNX2  genes were determined in the same 52 patients, CHST3, DLL3, MESP2, LFNG, HES 7.

RESULTS. It was found that, along with radiation methods of research, when deciding on the need for surgical intervention in congenital malformations of the spine, polymorphisms of detoxification genes, as well as their relationship with biochemical parameters of blood, and heavy metals in biological substrates, can be used.

CONCLUSION. The question of the need for surgical treatment for congenital malformations of the spine can be resolved using radiation diagnostic methods, which requires a long observation time. Combining the radiation method and the method for determining the aggressiveness of the course of the disease using the relationship of detoxification gene mutations with biochemical parameters will significantly reduce the decision-making time, taking into account clinical data.

About the Authors

A. V. Belecky
Minsk Central District Clinical Hospital
Belarus

Minsk



T. V. Zhukava
MITSO
Belarus

Minsk



K. V. Pustovoytov
Republican Scientific and Practical Centre for Traumatology and Orthopedics
Belarus

Minsk



A. A. Kartyzhova
Republican Scientific and Practical Centre for Traumatology and Orthopedics
Belarus

Minsk



D. K. Tesakov
Republican Scientific and Practical Centre for Traumatology and Orthopedics
Belarus

Minsk



В. Марчук
Republican Scientific and Practical Centre for Traumatology and Orthopedics
Belarus

Minsk



C. V. Makarevich
Republican Scientific and Practical Centre for Traumatology and Orthopedics
Belarus

Minsk



L. M. Shevchuk
Belarusian State Medical University
Belarus

Minsk



References

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For citations:


Belecky A.V., Zhukava T.V., Pustovoytov K.V., Kartyzhova A.A., Tesakov D.K.,  , Makarevich C.V., Shevchuk L.M. Algorithm for choosing the tactics of treating patients with congenital spinal deformities. Russian Neurosurgical Journal named after Professor A. L. Polenov. 2022;14(1-2):5-7. (In Russ.)

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ISSN 2071-2693 (Print)