Коррекция идиопатического сколиоза у детей под контролем 3D-КТ-навигации

Objective. To analyze results of surgical correction of thoracic idiopathic scoliosis in children using the system of active optical 3D-CT navigation and preoperative CT images with anatomical landmark-based registration. Material and Methods. Eighteen patients aged 15 to 17 years (14 girls and 4 boys) with thoracic idiopathic scoliosis were operated on. The Cobb angle of the primary curvature ranged from 55 to 90 degrees. The surgery was performed through a posterior approach with simultaneous halo-tibial traction using multi-anchoring metal device with pedicle screws. Canals for screw insertion were formed under 3D-CT navigation control in accordance with preoperative planning. Results. The extension of fixation for thoracic type of deformity varied between 10 and 13 vertebrae (from T2 to L4). The number of pedicle screws per patient ranged from 19 to 26 (average 24 screws). Thus, 429 screws were placed in 18 patients: 305 in thoracic spine and 124 in the lumbar spine. Postoperative correction of the coronal plane deformity ranged from 92 % to 99 %, and derotational correction of the apical vertebra from 72 % to 94 %. Conclusion. Intraoperative optical 3D-CT navigation with the processing of preoperative CT images and registration based on anatomical landmarks ensures the accuracy of pedicle screws placement, which allows using this type of correction devices even for severe thoracic deformities.