Abstract
Objective. To analyze morphological features of tissue structures (bone and muscle tissue) and their correlation with osteodensitometry data for predicting the volume of intraoperative blood loss in surgery for idiopathic scoliosis. Material and Methods. Articular processes of vertebrae and fragments of muscle tissue obtained from 50 patients undergoing surgery for idiopathic scoliosis were investigated. All patients underwent osteodensitometry before surgery. Data on the volume of intraoperative blood loss were analyzed. Results. Morphologic study of specimens (n = 21) revealed significant features: atrophy of bone trabeculae with irregular arrangement of osteocytes, widening of intertrabecular spaces, large number of hemosiderophages in the bone marrow, absence of the process of osteogenesis, atrophy of muscle fibers, and enlarged thin-walled vessels. Intraoperative blood loss in patients with these observations - from 30 to 50 % of total blood volume, and osteodensitometry revealed osteoporosis. The study found a weak correlation between indicators of bone density and volume of intraoperative blood loss. Conclusion. Morphological changes in bone and muscle tissue in patients with idiopathic scoliosis are risk factors for massive blood loss in surgery for scoliosis. Findings of preoperative osteodensitometry may be an indirect predictor of the volume of intraoperative blood loss.
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