CORRECTION OF IDIOPATHIC SCOLIOSIS IN CHILDREN UNDER 3D-CT NAVIGATION*

Objective. To analyze the results of surgical correction of thoracic idiopathic scoliosis in children using the system of active optical 3D-CT navigation and preoperative CT imaging 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 subjected to surgical treatment. The Cobb angle of the primary curvature ranged from 55 to 90 degrees. The surgery was performed through the posterior approach with simultaneous halo-tibial traction using a multianchoring metal device with pedicle screws. Canals for screw insertion were formed under 3D-CT navigation control in accordance with preoperative planning. Results. The extention of fixation for the thoracic type of deformity varied between 10 and 13 vertebrae (from T2 to L4). The number of pedicle screws elements per patient ranged from 19 to 26 (on average 24 screws). Thus, 429 screws were installed into 18 patients: 305 in the 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 processing of preoperative CT images and registration based on anatomical landmarks ensures the accuracy of placement of pedicle screws, which enables the use of this type of correction devices even for severe thoracic deformities.