EXPERIENCE IN THE USE OF HYBRID INSTRUMENTATION IN SURGICAL TREATMENT OF THORACIC IDIOPATHIC SCOLIOSIS WITH LUMBAR COUNTER-CURVE
https://doi.org/10.14531/ss2015.4.30-35
Abstract
Objective. To analyze results of surgical treatment of patients with thoracic idiopathic scoliosis with lumbar counter-curve using hybrid instrumentations.
Material and Methods. A total of 86 patients (10 boys and 76 girls) with Lenke type III idiopathic scoliosis were operated on. The average age of patients was 15.3 ± 1.8 (range: 10.3-18.0) years, with mean follow-up of 3.5 ± 0.7 (range: 2.2-5.7) years. All patients underwent correction of spinal deformity by hybrid instrumentation with laminar fixation of the thoracic spine and lumbar transpedicular fixation of the thoracolumbar spine. Postoperatively, patients were interviewed using SRS-24 questionnaire.
Results. The average initial magnitude of primary thoracic curve was 63.4° ± 19.2°, immediately after surgery - 19.0° ± 10.0°; correction - 45.3° ± 15.5°; postoperative progression was 1.3° ± 3.7°. The initial magnitude of counter-curve was 41.0° ± 19.9°, immediately after surgery 10.4° ± 11.9°; correction 28.9° ± 17.8°; postoperative progression was 0.6° ± 2.1°. The tilt angle of the lower instrumented vertebra decreased after surgery from 21.2° ± 9.7° to 5.5° ± 4.2°, at the last follow-up examination it almost did not change - 5.4° ± 3.9°. The questionnaire results demonstrated a high degree of patient satisfaction with the treatment. Severe complications were not observed.
Conclusion. The use of hybrid instrumentation in the treatment of patients with thoracic idiopathic scoliosis and lumbar counter-curve allows achieving good correction of spinal deformity and sustain the achieved correction.
About the Authors
Aleksandr Sergeyevich Vasyura
Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan, Russia
Russian Federation
Russian Federation
Vyacheslav Viktorovich Novikov
Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan, Russia
Russian Federation
Russian Federation
Vadim Vasilyevich Belozerov
Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan, Russia
Russian Federation
Russian Federation
Inga Gennadyevna Udalova
Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan, Russia
Russian Federation
Russian Federation
References
1. Васюра А.С., Новиков В.В., Белозеров В.В., Удалова И.Г. Эффективность применения ламинарной и транспедикулярной фиксации при хирургическом лечении идиопатического сколиоза поясничной и грудопоясничной локализации // Хирургия позвоночника. 2012. № 1. С.48-53. DOI: http://dx.doi.org/10.14531/ss2012.1.48-53.
2. Виссарионов С.В., Кокушин Д.Н., Дроздецкий А.П., Белянчиков С.М. Технология использования 3D-КТ-навигации в хирургическом лечении детей с идиопатическим сколиозом // Хирургия позвоночника. 2012. № 1. С. 41-47. DOI: http://dx.doi.org/10.14531/ss2012.1.41-47.
3. Виссарионов С.В., Соболев А.В., Ефремов А.М., Лягуша А.В. Хирургическое лечение детей с идиопатическим сколиозом грудопоясничной и поясничной локализации III-IV степени с использованием транспедикулярных спинальных систем // Материалы VI съезда Ассоциации хирургов-вертебрологов «Вертебрология в России: перспективы, проблемы и пути решения». Краснодар, 2015. Т. 1. С. 10-15.
4. Колесов С.В., Кудряков С.А., Шавырин И.А. Хирургическая коррекция грудного сколиоза из вентрального и дорсального доступов // Хирургия позвоночника. 2013. № 2. С. 14-22.
5. Михайловский М.В., Фомичев Н.Г. Хирургия деформаций позвоночника. Новосибирск, 2011.
6. Хирургия идиопатического сколиоза: ближайшие и отдаленные результаты. Новосибирск, 2007. С. 111-127.
7. Barr SJ, Schuette AM, Emans JB. Lumbar pedicle screws versus hooks. Results in double major curves in adolescent idiopathic scoliosis. Spine. 1997; 22: 1369-1379.
8. Bullmann V, Liljenqvist UR, Schmidt C, Schulte TL. [Posterior operative correction of idiopathic scoliosis. Value of pedicle screws versus hooks]. Orthopade. 2009; 38: 198-200. In German. DOI: 10.1007/s00132-008-1370-x.
9. Cotrel Y, Dubousset J. CD Instrumentation in Spine Surgery. Principles, Technicals, Mistakes and Traps. Sauramps Medical, 11 boulevard Henry IY, 34000 Montpellier, 1992.
10. Kim YJ, Lenke LG, Kim J, Bridwell KH, Cho SK, Cheh G, Sides B. Comparative analysis of pedicle screw versus hybrid instrumentation in posterior spinal fusion of adolescent idiopathic scoliosis. Spine. 2006; 31: 291-298. DOI: 10.1097/01.brs.0000197865.20803.d4.
11. Lehman RA Jr, Lenke LG, Keeler KA, Kim YJ, Buchowski JM, Cheh G, Kuhns CA, Bridwell KH. Operative treatment of adolescent idiopathic scoliosis with posterior pedicle screw-only constructs: minimum three-year follow-up of one hundred fourteen cases. Spine. 2008; 33: 598-604. DOI: 10.1097/BRS.0b013e318178872a.
12. Lenke LG, Betz RR, Harms J, Bridwell KH, Clements DH, Lowe TG, Blanke K. Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis. J Bone Joint Surg Am. 2001; 83: 1169-1181.
13. Lowenstein JE, Matsumoto H, Vitale MG, Weidenbaum M, Gomez JA, Lee FY, Hyman JE, Roye DP Jr. Coronal and sagittal plane correction in adolescent idiopathic scoliosis: a comparison between all pedicle screw versus hybrid thoracic hook lumbar screw constructs. Spine. 2007; 32: 448-452. DOI: 10.1097/01.brs.0000255030.78293.fd.
14. Rose PS, Lenke LG, Bridwell KH, Mulconrey DS, Cronen GA, Buchowski JM, Schwend RM, Sides BA. Pedicle screw instrumentation for adult idiopathic scoliosis: an improvement over hook/hybrid fixation. Spine. 2009; 34: 852-857. DOI: 10.1097/BRS.0b013e31818e5962.
15. Roy-Camille R, Saillant G, Mazel C. Internal fixation of the lumbar spine with pedicle screw plating. Clin Orthop Relat Res. 1986; (203): 7-17. DOI: 10.1097/00003086-198602000-00003.
16. Suk SI, Lee CK, Kim WJ, Chung YJ, Park YB. Segmental pedicle screw fixation in the treatment of thoracic idiopathic scoliosis. Spine. 1995; 20: 1399-1405.
Review
For citations:
Vasyura A.S., Novikov V.V., Belozerov V.V., Udalova I.G. EXPERIENCE IN THE USE OF HYBRID INSTRUMENTATION IN SURGICAL TREATMENT OF THORACIC IDIOPATHIC SCOLIOSIS WITH LUMBAR COUNTER-CURVE. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2015;12(4):30-35. https://doi.org/10.14531/ss2015.4.30-35
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