Scoliosis is a triplanar spinal deformity, in which the basic rules of surgery consist of: curve correction in frontal plane and normal sagittal alignment restoration. The main aim of the work is the preparation of an instrumentation algorithm for posterior approach surgery in idiopathic scoliosis. Material consists of 150 patients, 136 females and 14 males. The mean age at the time of surgery was 15.5 years with the follow up time of 3.7 years. The curve angle according to Cobb was in thoracic spine mean 56.1o, and in lumbar spine 51.2o. All the patients underwent posterior fusion with derotational instrumentation Radiological assessment was performed using postero-anterior, lateral and elongation radiograms. Own scale of treatment result evaluation was introduced. Mean correction of thoracic curve was 61.8% and lumbar curve - 66.6%. Good results in frontal plane were noted in 97 cases (65%) and bad in 53 (35%). In sagittal plane, good results were in 112 patients (75%), and bad in 38 (25%) patients. Good result in both planes was observed in 76 cases (51%), and bad – in 24 (16%) patients. Upper end of instrumentation tied in with upper neutral vertebra and use of lumbar pedicular screws give good end result. Fusion up to L3 vertebra gives bad result in frontal plane. Reverse hooks at the end of fusion cause good sagittal result. Fusion to L4 is particularly advised when: lumb ; ar Cobb angle >60o; elongation lumbar angle ≥25o; AVT2 ≥35 mm, lordosis <30o and kyphosis <20o; L4 angle and LS angle >10o; improper position of L4 vertebra.
27 lut 2023
21 lis 2012
26
0
http://dl.cm-uj.krakow.pl:8080/publication/949
Nazwa wydania | Data |
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ZB-106435 | 27 lut 2023 |
Jasiewicz, Barbara
Rożek, Karina
Potaczek, Tomasz
Jasiewicz-Honkisz, Barbara