Objective. To access the efficacy of surgical treatment of scoliosis using anterior approach. Material and Methods. Twenty four patients aged 9-18 years (22 females, 2 males) were operated on. Twelve patients had thoracic deformity, and 12-thoracolumbar and lumbar. Correction was performed through anterior approach using thoracotomy and thoracophrenolumbotomy with single and double rod instrumentation. Results. Mean correction of thoracic deformity was 84 %, mean number of fixed vertebrae was 7. Mean correction of lumbar and thoracolumbar deformity was 74 %, mean number of fixed vertebrae-6. In all cases a good sagittal alignment of the spine was achieved. Conclusion. Anterior correction is indicated for Lenke type I and V scoliotic deformity. Anterior instrumentation is feasible for thoracic deformity below 75°, and for thoracolumbar and lumbar-below 85°.
A case of surgical treatment of C6 fracture-dislocation and C7 fracture in a patient with ankylosing spondylitis is presented. Two-stage surgery with reposition of fracture-dislocation using the halo apparatus and stabilization with segmental instrumentation was performed. Outcome of the surgical treatment included elimination of deformity, achievement of stable fixation, and reduction of neurological signs observed in the patient before surgery.
Two-step surgical treatment was conducted in a 17 year old woman with extremely severe kyphoscoliotic deformity on the background of spinal muscular atrophy. At first step a ring of haloapparatus was assembled and gradual halotraction was performed in an armchair within 21 days. Second step included dorsal correction and stabilization of scoliosis by hybrid fixation system at Th3-L4 level with pelvis fixation. As a result of surgical intervention a proper trunk balance was formed, pelvic deformity was diminished, selfservice and use of wheelchair in a sitting position was improved.
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