Multimodal Surgical Treatment of Severe Scoliosis Using Concave Thoracoplasty
Objective. To analyze results of multimodal surgical treatment of patients with severe scoliosis involving concave thoracoplasty. Material and Methods. A total of 40 patients aged from 12 to 31 years with spinal deformities of 70-150° were operated on with posterior CD instrumentation combined with elevating thoracoplasty on the concave side of the thorax deformity. Mean follow-up period was 2 years. Dynamics of the respiratory function was studied. Patients underwent X-ray and CT examinations of the spine, and appearance assessment. Results. The mean preoperative Cobb angle of the major thoracic curve was 101° (range: 70-150°), and postoperative - 47°; postoperative correction was 54° (53 %). The loss of correction was not practically registered at the immediate and long-term follow-up. The mean preoperative Cobb angle of the compensatory lumbar curve was 50.5°, and postoperative - 20.6°. The mean thoracic kyphosis was 51° before surgery and 28.7° after surgery. The mean lung vital capacity was 56.3 % before surgery, and 66.5% in 12 months after surgery. Conclusion. Concave thoracoplasty provides increased mobility of the deformity, and improvement of stabilization, cosmetic and functional results of surgical treatment of patients with severe scoliosis.