Surgical Treatment of Scoliosis during the Period of Uncompleted Spine Growth

Outcomes of surgical treatment of 34 patients aged from 9 to 15 years (mean age
11.7 years) with basic curvature arch from 43 to 148° (99° average). In 9 patients dorsal correction and spine fixation by CD system without intervention on the vertebral bodies was performed (1st group). In 25 patients diskepiphysectomy (including thoracoscopic one in
7 patients) and interbody spondylodesis on the apex of the convex basic arch were performed prior to dorsal correction. Then halo-pelvic traction was performed for 7-10 days followed by dorsal fixation of the spine by CDI without posterior spondylodesis (2nd group). Subsequently depending on the degree of correction loss due to spine growth step-by-step corrections of the deformity were performed. After spine growth completion final instrumental correction and fixation of the spine with posterior spondylodesis were performed. In the 1st group step-by-step corrections were to be performed in 77% of cases, in 2nd group - in 28% only. It was shown that performance of diskepiphysectomy on the apex of the deformity with following correction and CD system fixation of the spine decreased the rate of postoperative spine deformity progression, eliminated asymmetric growth of vertebrae on the deformity and increased the achieved correction. In the process of patients' growth wedge shape of the vertebral bodies decreased in frontal and sagittal planes and no increase of their torsion-rotation changes occurred.

scoliosis, infantile scoliosis, juvenile scoliosis, dorsal instrumentation, halo-pelvic traction, diskepiphysectomy, thoracoscopic diskepiphysectomy