Surgical treatment of progressive idiopathic scoliosis in adolescents aged 10–14 years: literature review

Objective. To  perform a systematic review  of publications devoted to the  evaluation of the  results of surgical treatment of adolescents with idiopathic scoliosis aged 10–14 years.

Material and Methods. Publications on surgery for adolescent idiopathic scoliosis for the last 40 years were analyzed taking into account different  treatment approaches. The  long-term results of surgical correction and complications occurred at different stages of the  vertebrology development were reviewed based on the data of 23 publications including data on 826 patients aged 10 to 14 years in the period of active growth.

Results. The  prevalence of anterior interventions such as discectomy and anterior spinal fusion at the early stages of the scoliosis surgery development was justified. This was due  to the  lack of instrumentation at that time to prevent postoperative progression of scoliotic deformity in growing patients. The  occurrence of crankshaft phenomenon was prevented by performing intraoperative spine release and subsequent stabilization owing to the  formation of interbody bone  block.

Conclusion. Despite the  fact that the  method of total transpedicular fixation occupies a leading position at the  present stage of scoliosis surgery evolution, the  anterior spinal release remains relevant and necessary stage of surgical treatment of patients with severe and rigid spinal deformities at any age. The  need for anterior intervention is determined not  by the prevention of possible postoperative progression, but by the  magnitude of spinal deformity, that is, anterior surgery is performed to mobilize severe and rigid scoliotic deformity.

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