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EFFICACY OF LAMINAR AND TRANSPEDICULAR FIXATION IN SURGICAL TREATMENT OF THORACOLUMBAR AND LUMBAR IDIOPATHIC SCOLIOSIS

Objective. Comparative analysis of surgical results in patients with thoracolumbar and lumbar idiopathic scoliosis treated by laminar and transpedicular fixation. Materials and Methods. Two groups of patients with lumbar and thoracolumbar idiopathic scoliosis were operated on. Group 1 patients underwent skeletal traction applied to calvarial bones and supramalleolar area, and correction of spinal deformity with third-generation hybrid segmental instrumentation using laminar fixation in the thoracic spine and transpedicular fixation in the lumbar or thoracolumbar spine. Results. In group 1, the scoliotic deformity was reduced on average from 63.8 ± 21.1° to 24.7 ± 13.7°; postoperative progression was 6.8 ± 1.1° (18.6 ± 2.5 %); and tilt angle of the lower instrumented vertebra before the surgery, after the surgery, and at follow-up was 9.5 ± 8.4°, 8.2 ± 5.4°, and 10.0 ± 5.9°, respectively. In group 2, the deformity was reduced on average from 55.9 ± 16.6° to 13.4 ± 11.2°; postoperative progression was 2.4 ± 0.7° (5.8 ± 1.8°); and tilt angle of the lower instrumented vertebra before the surgery, after the surgery, and at follow-up was 17.6 ± 7.6°, 5.2 ± 4.3°, and 5.6 ± 4.5°, respectively. Conclusion. Transpedicular fixation is the more effective technique of surgical treatment for lumbar and thoracolumbar scoliosis than laminar fixation.