METHOD OF PRE-SURGICAL PLANNING FOR CARRYING OUT SURGICAL THERAPY OF COARSE FORMS OF IDIOPATHIC SCOLIOSIS

摘要

FIELD: medicine, traumatology, orthopedics.;SUBSTANCE: the innovation suggested deals with applying segmental endocorrectors and intra-surgical skeletal traction. To achieve optimal correction of vertebral deformation at detecting the volume, stage-by-stage nature and character of surgical interference it is necessary to carry out certain vertebral roentgenograms under conditions of vertical traction by a patient's head at full body weight at clinical neurological monitoring; evaluate functional vertebral mobility to estimate the dynamics of neurological status. In case of complete absence of vertebral deformation mobility and availability of neurological deficiency in case of traction impact it is not useful to apply intra-surgical traction and on installing the equipment one should conduct the test at awakening for intra-surgical neurological monitoring to exclude neurological complications. In case of inconsiderable mobility (the value of residual deformation being above 80°) and the absence of neurological symptomatics it is possible to plan a three-stage surgical therapy that includes mobilizing diskectomy for the length of thoracic scoliotic arch, application of skeletal traction beyond the bones of cranial arch and supramalleolar areas along with traction intra-surgical impact, correction of vertebral deformation with the help of segmental instruments and posterior spondylodesis, moreover, it is necessary to carry out intra-surgical test at awakening. In case of moderate mobility (the value of residual deformation being above 60°) and the absence of neurological symptomatics one should plan a two-stage surgical therapy that includes application of skeletal traction by the bones of cranial arch and supramalleolar areas along with traction intra-surgical impact, correction with segmental instruments and posterior spondylodesis.;EFFECT: higher efficiency.;3 ex