THE 3D-CT NAVIGATION TECHNOLOGY FOR SURGICAL TREATMENT OF CHILDREN WITH IDIOPATHIC SCOLIOSIS

Abstract

Objective. To study an applicability of active optical 3D-CT navigation system for surgical treatment of children with idiopathic scoliosis. Material and Methods. The study included 12 children aged 14-17 years with thoracic and thoracolumbar idiopathic scoliosis. The magnitude of scoliotic deformity varied from 52° to 80° (average 70°). Correction of deformity was performed using multisegmental pedicle screw instrumentation inserted under the guidance of active optical 3D-CT navigation system. At the stage of navigation an estimation of mean-square registration error, and monitoring of time required for registration and formation of bone canals for pedicle screws were performed. Results . In 96.6 % of cases the pedicle screws were placed in all preplanned pedicles. In other 9 vertebrae (3.4 %) the screw placement was complicated by pedicle fracture and screw trajectory deviation. There were no cases of neurological and infection complications, and instrumentation loosening in the studied patients. Conclusion. Active optical 3D-CT navigation using preoperative CT images and anatomical landmark registration is applicable in correction of idiopathic scoliosis in children. Multisegmental transpedicular fixation allows reducing the length of metal fixation zone, and achieving maximum curve correction and reliable stability.