EFFICACY OF LAMINAR AND TRANSPEDICULAR FIXATION IN SURGICAL TREATMENT OF THORACOLUMBAR AND LUMBAR IDIOPATHIC SCOLIOSIS

Abstract

Objective. Comparative analysis of surgical results in patients with thoracolumbar and lumbar idiopathic scoliosis treated by laminar and transpedicular fixation. Material and Methods. Two groups of patients with lumbar and thoracolumbar idiopathic scoliosis were operated on. Patients from Group 1 underwent skeletal traction applied to calvarial bones and supramalleolar area, and correction of spinal deformity with third-generation segmental instrumentation using laminar fixation. Patients from Group 2 underwent skeletal traction applied to calvarial bones and supramalleolar area, and correction of spinal deformity with third-generation hybrid segmental instrumentation using laminar fixation in the thoracic spine and transpedicular fixation in the lumbar or thoracolumbar spine. Results. In Group 1 the scoliotic deformity was reduced from an average of 63.8° ± 21.1° to 24.7° ± 13.7°; postoperative progression was 6.8° ± 1.1° (18.6 ± 2.5 %); and tilt angle of the lower instrumented vertebra before surgery, after surgery, and at follow-up was 9.5° ± 8.4°, 8.2° ± 5.4°, and 10.0° ± 5.9°, respectively. In Group 2 the deformity was reduced from an average of 55.9° ± 16.6° to 13.4° ± 11.2°; postoperative progression was 2.4° ± 0.7° (5.8 ± 1.8 %); and tilt angle of the lower instrumented vertebra before surgery, after surgery, and at follow- up - 17.6° ± 7.6°, 5.2° ± 4.3°, and 5.6° ± 4.5°, respectively. Conclusion. Transpedicular fixation is more effective technique of surgical treatment for lumbar and thoracolumbar scoliosis than laminar fixation.