EFFICACY OF LAMINAR AND TRANSPEDICULAR FIXATION IN SURGICAL TREATMENT OF THORACOLUMBAR AND LUMBAR IDIOPATHIC SCOLIOSIS
https://doi.org/10.14531/ss2012.1.48-53
Abstract
Objective. Comparative analysis of surgical results in patients with thoracolumbar and lumbar idiopathic scoliosis treated by laminar and transpedicular fixation.
Material and Methods. Two groups of patients with lumbar and thoracolumbar idiopathic scoliosis were operated on. Patients from Group 1 underwent skeletal traction applied to calvarial bones and supramalleolar area, and correction of spinal deformity with third-generation segmental instrumentation using laminar fixation. Patients from Group 2 underwent skeletal traction applied to calvarial bones and supramalleolar area, and correction of spinal deformity with third-generation hybrid segmental instrumentation using laminar fixation in the thoracic spine and transpedicular fixation in the lumbar or thoracolumbar spine.
Results. In Group 1 the scoliotic deformity was reduced from an average of 63.8° ± 21.1° to 24.7° ± 13.7°; postoperative progression was 6.8° ± 1.1° (18.6 ± 2.5 %); and tilt angle of the lower instrumented vertebra before surgery, after surgery, and at follow-up was 9.5° ± 8.4°, 8.2° ± 5.4°, and 10.0° ± 5.9°, respectively. In Group 2 the deformity was reduced from an average of 55.9° ± 16.6° to 13.4° ± 11.2°; postoperative progression was 2.4° ± 0.7° (5.8 ± 1.8 %); and tilt angle of the lower instrumented vertebra before surgery, after surgery, and at follow- up - 17.6° ± 7.6°, 5.2° ± 4.3°, and 5.6° ± 4.5°, respectively.
Conclusion. Transpedicular fixation is more effective technique of surgical treatment for lumbar and thoracolumbar scoliosis than laminar fixation.
About the Authors
A. S. Vasyura
Novosibirsk Research Institute of Traumatology and Orthopaedics
Russian Federation
Russian Federation
V. V. Novikov
Novosibirsk Research Institute of Traumatology and Orthopaedics
Russian Federation
Russian Federation
V. V. Belosyorov
Novosibirsk Research Institute of Traumatology and Orthopaedics
Russian Federation
Russian Federation
I. G. Udalova
Novosibirsk Research Institute of Traumatology and Orthopaedics
Russian Federation
Russian Federation
References
1. Ветрилэ С.Т., Кулешов А.А., Ветрилэ М.С. и др. Хирургическое лечение грудопоясничного и поясничного сколиоза // Хирургия позвоночника. 2004. № 2. С. 12-18.
2. Ветрилэ С.Т., Кулешов А.А., Швец В.В. и др. Особенности течения и оперативного лечения диспластического поясничного и грудопоясничного сколиоза у детей и взрослых // Вестн. травматол. и ортопед. им. Н.Н. Приорова. 2011. № 2. С. 71-80.
3. Asghar J, Samdani AF, Pahys JM, et al. Computed tomography evaluation of rotation correction in adolescent idiopathic scoliosis: a comparison of an all pedicle screw construct versus a hook-rod system. Spine. 2009;34:804-807.
4. Azlan AM, Mohammad AR, Ariffin AK. The HUKM Spinal Instrumentation System for adolescent idiopathic scoliosis. A biomechanical comparison study using finite element analysis. Med J Malaysia. 2005;60(Suppl):30-34.
5. Bullmann V, Liljenqvist UR, Schmidt C, et al. [Posterior operative correction of idiopathic scoliosis. Value of pedicle screws versus hooks]. Orthopade. 2009;38:198-200. German.
6. Christodoulou A, Ploumis A, Zidrou C, et al. Idiopathic scoliosis. Segmental fusion with transpedicular screws. Stud Health Technol Inform. 2002;91:433-437.
7. Deviren V, Acaroglu E, Lee J, et al. Pedicle screw fixation of the thoracic spine: an in vitro biomechanical study on different configurations. Spine. 2005;30:2530-2537.
8. Dobbs M, Lenke L, Kim Y. Posterior spinal fusion with pedicle screws. In: Master Techniques in Orthopaedic Surgery: Pediatrics. 1st Edition. Lippincott Williams & Wilkins, 2008:29.
9. Girardi FP, Boachie-Adjei O, Burke SW, et al. Surgical treatment of adolescent idiopathic scoliosis: a comparative study of two segmental instrumentation systems. J Spinal Disord. 2001;14:46-53.
10. Halm H, Niemeyer T, Link T, et al. Segmental pedicle screw instrumentation in idiopathic thoracolumbar and lumbar scoliosis. Eur Spine J. 2000;9:191-197.
11. Hamill CL, Lenke LG, Bridwell KH, et al. The use of pedicle screw fixation to improve correction in the lumbar spine of patients with idiopathic scoliosis. Is it warranted? Spine. 1996; 21:1241-1249.
12. Lee SM, Suk SI, Chung ER. Direct vertebral rotation: a new technique of three-dimensional deformity correction with segmental pedicle screw fixation in adolescent idiopathic scoliosis. Spine. 2004;29:343-349.
13. Lenke LG, Betz RR, Harms J, et al. Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis. J Bone Joint Surg Am. 2001;83:1169-1181.
14. Shufflebarger HL, Geck MJ, Clark CE. The posterior approach for lumbar and thoracolumbar adolescent idiopathic scoliosis: posterior shortening and pedicle screws. Spine. 2004;29:269-276.
Review
For citations:
Vasyura A.S., Novikov V.V., Belosyorov V.V., Udalova I.G. EFFICACY OF LAMINAR AND TRANSPEDICULAR FIXATION IN SURGICAL TREATMENT OF THORACOLUMBAR AND LUMBAR IDIOPATHIC SCOLIOSIS. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2012;(1):48-53. (In Russ.) https://doi.org/10.14531/ss2012.1.48-53
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