Surgical treatment of idiopathic scoliosis

Abstract

Introduction. Scoliosis is a complex deformity of the spine with a sideways curvature and vertebral torsion, with changes into neuro-muscular and connective tissues, with functional and organic disorders of different severity, with damage of the human psyche and psychosocial disability. The incidence of scoliotic deformities in adolescents is 14-17% and in idiopathic ones is 15,3% of the population with a ratio by gender women and men 3,5:1.The treatment of scoliosis is still far from being perfect, even though there are numerous contemporary methods of conservative and surgical treatment, performed at posterior and anterior structures of the spine. Aim of the study. The purpose was to study and analyse the importance, efficiency, complications, the advantages and disadvantages of the new surgical procedures of correction, reconstruction and stabilization of the vertebral column of patients with scoliotic deformities of the spine, also to improve the outcome results in the surgical treatment all being based on a complex clinic-imagistical study. Materials and methods. In order to fulfill the tasks, were analysed the results of surgical treatment applied during the period of 2017-2019 to the patients between 13 and 64 years old. To perform comparative analysis of surgical treatment all patients have been divided depending on age, sex, the surgical method, the type of spine deformity, the curative strategy, the implanted metallic construction, surgical approach. Results. The average duration of intervention: 207,1±7,9 min. Intraoperative hemorrhage: 638,2±3,7 ml. The angle of deformity of the primary curvature: 46,6o – preoperative, postoperative correction: 22,2o. The postoperative correction kept: 28,7o. Conclusions. The treatment of choice of severe forms of scoliosis remains the surgical correction of the spine. This allows the angle of scoliosis deformations to be reduced, correction of pulmonary, heart, vessels position. The efficiency of surgical treatment is appreciated not only by the cosmetic data obtained, but also by the re-establishment of the function of the organs. The possibilities of surgical correction of scoliosis is directly correlated with the age at which the patient was operated and with the size of the initially scoliotic deformity. In patients with finished bone growth is indicated a posterior thoracic spinal fusion at the top of the scoliosis curve. In patience with unfinished bone growth, the sublaminar wiring are required to be made as slider constructions which helps at longitudinal sliding in the growth process. These results provide useful information concerning the indications and strategies of scoliosis surgery.