Peculiarities of Course and Surgical Treatment for Dysplastic Lumbar and Thoracolumbar Scoliosis in Children and Adults



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Abstract

Analysis of CITO outpatient department archives has shown that practically from 20 to 30% of patients with spine pathology are suffering from scoliosis. The most common types are lumbar and thoracolumbar scoliosis. Progression of lumbar scoliosis goes on after growth completion and is accompanied by formation of pronounced degenerative changes in the spine. Clinically the course of the disease is aggravated by marked persistent pain syndrome. Results of surgical treatment performed at CITO spine pathology department with application of ventral and dorsal instrumentation have been analyzed for 118 patients with lumbar and thoracolumbar scoliosis. Eighty of those patients were operated on in childhood and juvenile age, 38 patients at the age of 25 - 70 years. Use of ventral instrumentation enabled to achieve high degree of lumbar and thoracolumbar scoliosis correction - up to 72% of initial deformity, average derotation made up 12.9° or 44.3% of initial rotation. Use of dorsal instrumentation is also effective for surgical treatment of lumbar and thoracolumbar scoliosis (66.8% of lateral curvature). Screw fixation ensures higher degree of the lateral curvature (68.2%) and sagittal profile as well as rotation component (33.1% of initial value). Presence of focal neurologic symptomatology is the indication to decompressive operations followed by instrumental fixation and posterior fusion. Defor-mity correction is performed only within the limits of deformity mobility

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