ANTERIOR INSTRUMENTATION IN SURGERY FOR LUMBAR AND THORACOLUMBAR IDIOPATHIC SCOLIOSIS

Objective. To analyze the long-term results of surgical correction of idiopathic scoliosis in the lumbar and thoracolumbar spine with anterior instrumentation. Material and Methods. A total of 24 patients (mean age – 18.2 years, male/female ratio – 3/21) were operated on using anterior tworod instrumentation system. The mean operating time was 170 minutes, and the mean blood loss – 374 ml. The average postoperative follow-up period was 50 months. Results. The primary curve was reduced from 48.7° to 14.8°o (69.6 %). Postoperative progression was 6.4°. Thoracic counter-curve underwent self-correction from 27.7° to 14.7°, postoperative progression was 3.0°. The thoracic kyphosis and lumbar lordosis remained within the normal ranges. Rotation of the apical vertebra before the operation was 27.8 %, immediately after the intervention – 17.5 %, at the end of the followup period – 17.1 %. Coronal imbalance before surgery was 24.7 mm, immediately after the intervention – 27.5 mm, at the end of the follow-up period – 7.1 mm. The patients’ self-evaluation of treatment outcomes was carried out using the Russian version of the SRS-24 questionnaire. At the first follow-up visit, patients reported expectedly lower postoperative function score and gave middle scores for the remaining domains. Later, there was a positive dynamics in all assessed parameters, most pronounced in pain syndrome, function and overall activity after surgery. Conclusion. Correction of idiopathic scoliosis of lumbar and thoracolumbar localization using anterior instrumentation is a highly effective method of treatment, which in most cases gives a stable positive result. However, the development of pronounced trunk imbalance in some patients requires the continuation of studies in order to optimize the technique for determining the optimal extent of the instrumented fusion.