Surgical treatment results of children with spinal and chest deformities with the use of the active optical three-dimensional computer navigation device

Idiopathic scoliosis (IS) accounts for 2% to 5% of cases in orthopedic pathology. Surgical treatment of severe, rigid IS forms remains an important and pressing problem. The purpose of this research was to evaluate the efficacy and safety of the surgical correction method of severe kyphoscoliotic deformity of the thoracic spine in children with the use of the active optical three-dimensional computer navigation technology. Materials and methods used: a retrospective, single-center cohort study of the surgical treatment results of 30 children aged 14 to 18 y/o with grade 4 IS was conducted with V (C) Level of Evidence. The inclusion criteria were as follows: the scoliotic deformity magnitude of over 80°, simultaneous discopphysectomy, mobilizing dorsal osteotomies and deformity correction with a multi-support metal structure. Results: the scoliosis magnitude in the preoperative period was 100.5° (min 82; max 130; SD=13.21), after surgery 27° (min 4; max 47; SD=12.53). Pairwise comparison demonstrated statistically significant differences (p=0.013). The kyphosis magnitude in the preoperative period was 39.4° (min 3; max 61; SD=16.61), after surgery - 37.7° (min 3; max 49; SD=6.59). The abovementioned data comparison demonstrated the absence of statistically significant differences (p=0.154). The vertebral rotation magnitude in the preoperative period was 35.5° (min 20; max 60; SD=8.73), after surgery - 20° (min 9; max 32; SD=6.54). When comparing the results, statistically significant differences were revealed (p=0.010). Neurological disorders after the surgical interventions were not noted in patients included in the study. Conclusion: the use of the method of surgical correction of severe kyphoscoliotic deformity of the spine from a combined approach using active optical three-dimensional computer navigation technology allows the complete correction of the spinal deformity, indirectly improving both the shape and the size of the chest and restoring the frontal and sagittal profiles of the spine.