DORSAL SURGICAL CORRECTION OF SCOLIOSIS WITH CDI WITH AND WITHOUT PRELIMINARY HALO-PELVIC-TRACTION

Objective. To estimate results of surgical treatment of mobile forms of high-grade scoliosis by CDI with preliminary halo-pelvic-traction and without it.

Material and Methods. The outcomes of surgery for III–IV Grade scoliosis in 70 patients were analyzed. One stage dorsal deformity correction with CDI combined with posterior spinal fusion was performed in 38 patients. In 32 patients the instrumented correction was preceded by halo-pelvic-traction without anterior release. Mobility of the spine was estimated with Kazmin’s stability index, mobility index, correction at traction, and index of postoperative correction.

Results. In Group 1 the Kazmin’s index of stability was 0.82, and in Group 2 – 0.85. The mobility index was 55.96 in Group 1, and 62.90 in Group 2. Correction at traction was 44.04 in Group 1, and 37.10 % in Group 2. In Group 1 the achieved correction was 56.4 % and in Group 2 – 55.4 %. In Group 1 a deformity correction with CDI exceeded initial spine mobility by 20 % and in Group 2 – by 40 %. In both groups a disc height increased by 40 % on a concave side and decreased by 20 % on a convex side. Lordoscoliosis predominated in both groups (17 patients in Group 1, 15 – in Group 2). Kyphoscoliosis was in 9 patients in Group 1, and in 8 – in Group 2. Postoperative sagittal profile became normal in a majority of patients in both groups. There was no considerable derotation in patients of Group 1. In Group 2 a rotation of the whole spine in one direction was recorded after halo-pelvic-traction.

Conclusion. The CDI allows achieving significant curve correction in patients with mobile forms of scoliosis (more than 50 %). Preliminary halo-pelvic-traction without anterior release could be effective in patients with severe and rather mobile forms of scoliosis.

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