Objective To investigate the effectiveness of multilevel Ponte osteotomies on maintenance and restoration of thoracic kyphosis in idiopathic scoliosis (IS) surgery. Methods Between March 2008 and February 2010, 42 patients with thoracic IS (Lenke type 1 curves) were corrected with posterior pedicle screw system. Multilevel Ponte osteostomies for posterior release was performed in 17 cases (group A), and the 3 segments near the apical vertebrae were selected as the osteotomy site; simple posterior soft tissue release was given in 25 cases (group B). There was no significant difference in sex, age, disease duration, lesion segments, coronary Cobb angle, thoracic kyphosis, Risser index, and bending flexibility between 2 groups (P gt; 0.05). The anteroposterior and lateral standing radiographs of the spine were taken to compare the effectiveness between 2 groups. Results Operation was successfully completed in all patients. The operation time and blood loss in group A were significantly greater than those in group B (P lt; 0.05). Spine dural injury and leakage of cerebrospinal fluid occurred in 1 case of group A, which was cured after compression on local area of the wound; the other patients had no intraoperative complications. The patients were followed up 2-4 years (mean, 2.8 years); no nerve injury, infection, or internal fixation failure occurred. No obvious correction loss was observed and the appearance and trunk balance were significantly improved. The coronal Cobb angles at 1 week and 2 years after operation were significantly improved when compared with preoperative ones in 2 groups (P lt; 0.05). There was no significant difference in the coronal Cobb angle and correction rate between 2 groups at 1 week and 2 years after operation (P gt; 0.05). Group A was significantly better than group B in the thoracic kyphotic angle and angle changes at 1 week and 2 years after operation (P lt; 0.05). Conclusion The posterior approach surgery with multilevel Ponte osteotomies can restore the thoracic kyphosis in IS, but it has no effect on coronal correction in Lenke type 1 curves.
Interfacility transport of critically ill children is an important part of pre-hospital emergency care. The development of 5th generation mobile networks has brought revolutionary changes to emergency medicine, which can realize real-time sharing of information between hospitals and transfer ambulance units. In order to give full play to the advantages of superior medical institutions in diagnosis and treatment technology, equipment resources, and realize the safe and fast transfer of critically ill children, the technical specifications for the construction of interfacility transport of critically ill children’s ambulances with 5th generation mobile networks are specially formulated to standardize the team building, equipment and materials, transport process and quality control requirements for critically ill children’s ambulance transport, so as to reduce the fatality rate of critically ill children and improve the prognosis.