Kyphoscoliotic spinal deformities associated with high risk of developing neurological deficits. Literature review

Abstract

This is a literature review on kyphoscoliotic deformities with a high risk of severe primary neurological deficit. The review is integrative in nature and was conducted using medical literature databases and search resources such as PubMed, Google Scholar, and eLibrary. The following aspects are covered: the etiology and pathogenesis of neurological deficits caused by the natural progression of deformities, the main principles, and directions of surgical treatment for neurologically complicated spinal deformities. The scientific literature describes the primary mechanisms of neurological deficit development: mechanical compression and traction of the spinal cord, as well as impaired circulation at the apex of the deformity. Surgical methods for treating neurologically complicated kyphotic and scoliotic deformities have evolved with advancements in spinal instrumentation and approaches. In the first half of the 20th century, various spinal canal decompression methods were described, including laminectomy, costotransversectomy, spinal cord mobilization, and spinal canal remodeling. In the second half of the 20th century, the development and active use of spinal instrumentation (sublaminar hooks, pedicle screws) enabled simultaneous decompression, fixation, stabilization, and correction of spinal deformities. Combining different stabilization and deformity correction methods with concurrent spinal canal decompression creates the conditions for restoring spinal cord function, leading to a regression of neurological deficits and preventing severe patient disability.