Idiopathic scolioosis: long-term results of treatment of patients with the method of transpedicular fixation. Retrospective longitudinal study

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BACKGROUND: Тhe study of the treatment results of patients with idiopathic scoliosis should include both objective assessment methods, such as radiography and multispiral computed tomography, and subjective methods related to the response of the patient or his/her parents to treatment. A set of indicators will only allow an objective assessment of the long-term treatment outcomes.

AIM: To examine long-term treatment results of posterior transpedicular fixation in patients with idiopathic scoliosis of varying severity.

MATERIALS AND METHODS: Long-term treatment results by posterior transpedicular fixation were studied in 300 patients with idiopathic scoliosis of varying severity. To assess the effectiveness of treatment, clinical and radiological diagnostic methods and SRS30 and SRS22 questionnaires were used.

RESULTS: Treatment results in 1 year were studied in all patients and in 2 years in 225 patients (75%). In 150 patients (50%), the long-term treatment results was studied in 5, and in 15 of them (10%) in 10–12 years. The achieved correction value was maintained with a slight loss depending on the magnitude of the initial deformity and correction achieved after the operation. The SRS22 questionnaire 2 years after treatment of grade II deformity (according to Chaklin) showed that the indicators of postoperative function and remained practically unchanged, and the scores on self-esteem, appearance, and attitude were higher (p <0.05). In grade IV deformity, the scores on the appearance and attitude of others were high without significant differences.

CONCLUSION: Dorsal correction of the spine using transpedicular implants in patients with idiopathic scoliosis allows obtaining good treatment outcomes, which was confirmed by the preservation of correction during dynamic X-ray examination and assessment using the SRS22 questionnaire.

作者简介

Yusif Zeynalov

Hospital of the Military Medical Department of the State Security Service of the Republic of Azerbaijan

编辑信件的主要联系方式.
Email: z.l.yusif@gmail.com
ORCID iD: 0000-0002-6390-0423

MD, Cand. Sci. (Med.), traumatologist-orthopedist

阿塞拜疆, Baku

Aleksander Burtsev

Ilizarov National Medical Research Center for Traumatology and Orthopedics

Email: bav31rus@mail.ru
ORCID iD: 0000-0001-8968-6528
SPIN 代码: 5275-8050

MD, Dr. Sci. (Med.), traumatologist-orthopedist

俄罗斯联邦, Kurgan

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2. Fig. 1. а — distribution of patients according to the deformity severity (according to Chaklin), b — diagram of the distribution of the spine deformity value in patients with idiopathic scoliosis (n=300).

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3. Fig. 1. а — distribution of patients according to the deformity severity (according to Chaklin), b — diagram of the distribution of the spine deformity value in patients with IS (n=300).

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4. Fig. 2. Diagram of changes in deformity angles before and after surgery, depending on the average value of the initial deformity (1–28.4 °; 2–42.3 °; 3–73.7 °; 4–88.3 °; 5–117.5 °).

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5. Fig. 3. Diagram of changes in the magnitude of deformity at 2 and 10 years after surgery, depending on the initial angle of deformity (1–28.4 °; 2–42.3 °; 3–73.7 °; 4–88.3 °; 5–117.5 °).

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6. Fig. 4. Appearance (a, b), X-rays (c, d) of the spine in patient A., 13 years old, before treatment, MSCT before treatment (e). The spine appearance and X-rays of 13-year old patient A. after surgery (f, g). The spine appearance and X-rays of patient A., one year and 4 months after surgery (h, i, j).

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7. Fig. 5. The clinical result of the data of the SRS30 questionnaire in points at degree III of deformity (a); the clinical result of the data of the SRS30 questionnaire in points at degree IV of deformity (b).

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8. Fig. 6. Appearance of patient S., born in 1985 (a, b). Spine X-rays in frontal and lateral views before treatment (c, d). The spine X-ray of the spine in frontal view after surgery (e). Photo from the operating room and the patient after the surgery (f, g). The spine X-rays in frontal and lateral views five (5) years after surgery (h, i). The spine X-rays in frontal and lateral views 9 years and 5 months after surgery (j, k). The patient photo 9 years and 5 months after surgery (l).

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