ANTERIOR CORRECTION OF SPINAL SCOLIOTIC DEFORMITY
https://doi.org/10.14531/ss2009.4.15-20
Abstract
Objective. To access the efficacy of surgical treatment of scoliosis using anterior approach.
Material and Methods. Twenty four patients aged 9–18 years (22 females, 2 males) were operated on. Twelve patients had thoracic deformity, and 12 – thoracolumbar and lumbar. Correction was performed through anterior approach using thoracotomy and thoracophrenolumbotomy with single and double rod instrumentation.
Results. Mean correction of thoracic deformity was 84 %, mean number of fixed vertebrae was 7. Mean correction of lumbar and thoracolumbar deformity was 74 %, mean number of fixed vertebrae – 6. In all cases a good sagittal alignment of the spine was achieved.
Conclusion. Anterior correction is indicated for Lenke type I and V scoliotic deformity. Anterior instrumentation is feasible for thoracic deformity below 75°, and for thoracolumbar and lumbar – below 85°.
About the Authors
Sergey Vasilyevich Kolesov
Central Institute of Traumatology and Orthopedics n.a. N.N. Priorov, Moscow
Russian Federation
Russian Federation
Stepan Anatolyevich Kudryakov
Central Institute of Traumatology and Orthopedics n.a. N.N. Priorov, Moscow
Russian Federation
Russian Federation
Ilya Aleksandrovich Shavyrin
Central Institute of Traumatology and Orthopedics n.a. N.N. Priorov, Moscow
Russian Federation
Russian Federation
Ilya Ilyich Melnikov
Central Institute of Traumatology and Orthopedics n.a. N.N. Priorov, Moscow
Russian Federation
Russian Federation
References
1. Михайловский М.В., Фомичев Н.Г. Хирургия деформаций позвоночника. Новосибирск, 2002.
2. Cil A., Pekmezci M., Yazici M., et al. The validity of Lenke criteria for defining structural proximal thoracic curves in patients with adolescent idiopathic scoliosis // Spine. 2005. Vol. 30. P. 2550–2555.
3. DeWald R.L. Spinal Deformities. The Comprhensive Text. Thieme Medical Publishers, 2003.
4. Deviren V., Patel V.V., Metz L.N., et al. Anterior arthrodesis with instrumentation for thoracolumbar scoliosis: co5mparison of efficacy in adults and adolescents // Spine. 2008. Vol. 33P. 1219–1223.
5. Dwyer A.F., Schaffer M.F. Anterior approach to scoliosis // J. Bone Joint Surg. 1974. Vol. 56-B. P. 218–224.
6. Kaneda K., Shono Y., Satoh S., et al. New anterior instrumentation for the management of thoracolumbar and lumbar scoliosis: Application of the Kaneda two-rod system // Spine. 1996. Vol. 21. P. 1250–1262.
7. Kaneda K., Shono Y. Kaneda anterior multisegmental instrumentation two-rod system for the treatment of thoracolumbar and lumbar scoliotic curvatures // The Textbook of Spinal Surgery, 2 ed., edited by K.H. Bridwell, R.L. De Wald. Philadelphia, 1997. P. 641–664.
8. Lenke L.G., Betz R.R., Harms J., et al. Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis // J Bone Joint Surg. Am. 2001. Vol. 83. P. 1169–1181.
9. Saraph V.J., Krismer M., Wimmer C. Operative treatment of scoliosis with the Kaneda anterior spine system // Spine. 2005. Vol. 30. P. 1616–1620.
10. Schulte T.L., Liljenqvist U., Hierholzer E., et al. Spontaneous correction and derotation of secondary curves after selective anterior fusion of idiopathic scoliosis // Spine. 2006. Vol. 31. P. 315–321.
11. Zielke K. Ventral derotation spondylodesis. Results of treatment of cases of idiopathic lumbar scoliosis (author’s transl) // Z. Orthop. Ihre Grenzgeb. 1982. Vol. 120. P. 320–329.
Review
For citations:
Kolesov S.V., Kudryakov S.A., Shavyrin I.A., Melnikov I.I. ANTERIOR CORRECTION OF SPINAL SCOLIOTIC DEFORMITY. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2009;(4):015-020. (In Russ.) https://doi.org/10.14531/ss2009.4.15-20
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