Characteristics of surgical treatment of patients with comorbidities in scoliotic disease

Abstract

A large number of studies deal with the study of the etiology and pathogenesis of scoliotic disease, since it is the most commondisease among all the pathologies of the supporting-motor system. Scoliosis is more common in patients aged 4 to 17. Itsfrequencyin the adult population reaches 18.2 cases per 1000 of population. The developed and widely applicable non-surgicaltherapy of moderate, progressive, and severe extent of disease do not always lead to positive outcomes. A variety of surgicalmethodsfor treating scoliosis is successfully used nowadays. Modern types of fixing hardware, including two-leg growingsystems,mostoften used in practice, allow simultaneous correction of vertebral deformity in three planes and reliably stabilizethe spinal column in a position closest to the physiological one. Since most organs and systems of the body are affected byscoliosis,it is necessary to take into account the characteristics of the comorbid background of patients for successful surgicaltreatmentand effective postoperative rehabilitation. Comorbidity creates special requirements for surgical and rehabilitationapproachto achieve biomechanically correct fitting of the structure and its rigid fixation on the supporting osseous structures.The aimof the study was to identify the most common comorbidities in patients with scoliosis admitted for surgical treatment,to highlight the features of surgical treatment and rehabilitation of these groups of patients.Materialand methods.Westudied118case histories of patients admitted for surgical treatment of scoliosis, monitoring characteristics of the periods of treatmentand rehabilitation after surgical correction of vertebral deformity.Results.Degenerativevertebral diseases, cardiovasculardevelopment abnormalities and diseases of the gastrointestinal tract were noted with the highest frequency as diseasesassociated with scoliosis. The characteristics of surgical approach in the correction of vertebral deformity depending on theidentifiedcomorbidity are generalized.Conclusions.Therevealedcomorbidity pattern indicates the fundamental generalityof the etiology of scoliosis and these diseases, as well as the pathogenetic role of vertebral deformities in the development ofa number of diseases. This fact must be taken into account when planning approaches to surgical interference and individualrehabilitationprogramin the early postoperative period.