SURGICAL TREATMENT OF THORACIC IDIOPATHIC SCOLIOSIS

Abstract

Objective. To analyze results of surgical treatment of patients with thoracic idiopathic scoliosis. Material and Methods. Fifty-two patients with Lenke type 1 idiopathic scoliosis were operated on. Follow-up periods ranged from 2 weeks to 8 years (mean 1.8 years). Surgical treatment included four types of operation: spine deformity correction with CD instrumentation; supramalleolar-andskull traction and CDI correction; discectomy and interbody fusion with bone autograft and CDI correction; supramalleolar- and-skull traction, discectomy and interbody fusion with bone autograft, and CDI correction. Patients were interrogated with pre- and postoperative SRS-24 questionnaires and examined with Computer Optical Topograph (COMOT). Results. Scoliosis was corrected from a mean of 67.7° to 26.6°, with a mean deformity value being 30.3° at the last follow- up. Thus, postoperative progression of the thoracic curve with a mean follow-up 1.8 years was 3.7° (9 % from the achieved correction). Anterior fusion provided a threefold decrease in postoperative progression. Sagittal shape of the thoracic and lumbar spine remained within norm limits. The location of the lowest instrumented vertebra (LIV) relative to a neutral vertebra, lower stable vertebra and neutralized disc did not reliably influence on the postoperative course. Postoperative deformity progression was associated only with increase in LIV tilt. SRS-24 data showed a high rate of patients’ satisfaction with the obtained effect of treatment, the rate growing with the extension of follow-up terms. Severe complications were not observed. Conclusion. Modern 3rd generation segmental instrumentation allows to obtain stable and high results of treatment for single curve thoracic idiopathic deformities, while all regularities of postoperative course are not fully understood yet.