Некоторые особенности оперативного лечения тяжелых форм идиопатического сколиоза подростков

Objective. To analyse the outcomes of surgery for severe idiopathic scoliosis. Material and Methods. Seventy nine patients at the age of 12 to 20 years (male and female ratio is 8:71) with spine deformity more than 90° operated on with CDI with ventral fusion (72 patients) and without it (7 patients) were examined. Average follow-up is 1.3 years. Data of X-ray, COMOT examination, intervertebral disk morphological study and Russian version of SRS-4 questionnairy were analyzed. Results. Average correction was 55.0°. Postoperative progression was 3.4°. CDI correction with previous intervertebral disk excision at the apex of scoliotic arch added 26.5° to preoperative correction in lateral bending, and in combination with skeletal traction – 40.6°. Counter-curvature initially averaged 69.7°, correction was 36.5°, and postoperative progression – 4.0°. Preoperative thoracic kyphosis was 59.6°, postoperative – 33.8°, lumbar lordosis was decreased from 68.1° to 48.7°. Patient’s satisfaction was 100.0 % and did not decline in time. Positive dynamics was noted in all parameters of dorsal trunk shape. Conclusion. Contemporary segmental instrumentation for treatment of severe idiopathic scoliosis allows achieving and reliably retaining substantial correction of deformity. Various types of preoperative traction can be replaced by intraoperative release of the deformed spine including discectomy.