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. BeleckyBelarus
Minsk
T. V. Zhukava
Belarus
Minsk
K. V. Pustovoytov
Belarus
Minsk
A. A. Kartyzhova
Belarus
Minsk
D. K. Tesakov
Belarus
Minsk
В. Марчук
Belarus
Minsk
C. V. Makarevich
Belarus
Minsk
L. M. Shevchuk
Belarus
Minsk
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Review
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.)