The Concept of Surgical Treatment of Various Forms of Scoliosis Using Modern Technologies

Abstract

Objective. Basing on authors’ experience and literature review to analyze the concepts of surgical treatment of scoliotic deformities depending on their type, severity, and localization. Material and Methods. Three hundred and sixty six patients with scoliosis were operated on for deformity correction with dorsal CDI and anterior Hopf and Antares instrumentations. Surgical technique was chosen depending on scoliosis type, deformity severity, patient’s age, and other parameters, and with the account for continuous analysis of immediate and long-term results. Thoracic scoliosis in 299 patients was treated by oneor two-stage surgery, halo-pelvic traction, and anterior release. Sixty seven patients with lumbar and thoracolumbar scoliosis underwent anterior and posterior correction with CD instrumentation. Results. Surgical treatment of severe scoliosis by single-step multilevel discectomy and posterior correction provided a mean correction of the total angle of 40-50°. Anterior release of the spine added 40% to the achieved correction. Deformity correction in patients with lumbar and thoracolumbar scoliosis was 40 % to 90 %. Somewhat better correction of total and central angles was observed after application of anterior instrumentation. Conclusion. Differentiated approach to surgical treatment of scoliosis depending on deformity type, mobility, and severity, as well as application of anterior release, halo-pelvic traction, and modern instrumentation allows achievement of optimal correction of deformity with good radiological and clinical outcome.