Ventral dynamic vs dorsal transpedicular correction and fixation in surgical treatment of idiopathic scoliosis Lenke 5C: comparison of long-term results

Autor: Vladimir Pereverzev, Sergey V Kolesov, Arkadii I. Kazmin, Natalia S. Morozova, Vladimir V. Shvets
Rok vydání: 2023
Zdroj: Traumatology and Orthopedics of Russia.
ISSN: 2542-0933
2311-2905
DOI: 10.17816/2311-2905-3189
Popis: Background.Despite the active implementation of the dynamic correction approach in idiopathic scoliosis, there are no data from comparative studies using dorsal correction and ventral dynamic correction, in particular in patients with completed and terminating growth. The aim of the study was to compare the clinical and radiological results of ASC using traditional dorsal fusion in the treatment of idiopathic Lenke 5 scoliosis in patients with completed or terminating growth. Material and methods.A retrospective non-randomized comparative study. X-ray data were analyzed before the operation, immediately after and more than 2 years after the operation. Blood loss, duration of hospital stay, duration of taking narcotic analgesics in the early postoperative period. Functional results were evaluated using the SRS-22 questionnaire. All clinical and radiological complications were registered. Results.A total of 86 pts. with Lenke 5 deformities (1 gp. , 54 pt, 2 gp. 32 pt.), mean age 22.612.8 and 27.310.9. In 1 gp., the Cobb angle before surgery was 64.416.9, with long-term FU 26.9 5.3. Kyphosis of Th10-L2 before surgery is 20.86.9, with remote observation of 13.12.2. The preoperative angle of the main arc in 2gp. was 52.49.6, with a distant observation of 24.6 9.2. Transient kyphosis of Th10-L2 before surgery is 19.67.5, with remote observation of 19.21.6. Rotation of the apical vertebra according to Nash and Moe in 1gp. before surgery 1.63 0.39, immediately after surgery 0.160.45 and 0.180.32 at the last examination. In patients with dynamic correction, these indicators were 1.82 0.35 before surgery and 0.810.39 at the last measurement. The average number of fixed levels was 6.41 in 1gp. and 5.61.5 in 2gp. The average preoperative lumbar lordosis was 43.512.1, with long-term follow-up 44.211.3, in the group with dynamic correction and in the group with rigid 42.98.7, with long-term FU 43.311.2 Conclusion.Both posterior fusion and dynamic ventral correction and fixation of idiopathic Lenke 5C scoliosis can provide a satisfactory result from the point of view of radiological data with initially similar magnitude of thoracolumbar deformities in patients with completed and terminating growth.
Databáze: OpenAIRE
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