СРАВНИТЕЛЬНЫЙ АНАЛИЗ КОРРЕКТНОСТИ УСТАНОВКИ ТРАНСПЕДИКУЛЯРНЫХ ВИНТОВ ПРИ ХИРУРГИЧЕСКОМ ЛЕЧЕНИИ ДЕТЕЙ С ИДИОПАТИЧЕСКИМ СКОЛИОЗОМ

Abstract

Objective. To perform comparative analysis of the accuracy of pedicle screw placement in spinal deformity correction in children with idiopathic scoliosis using 3D-CT navigation. Material and Methods . Surgical treatment of 96 patients aged 14–18 years with Lenke type I and V idiopathic scoliosis was performed. In the study group (n = 66), pedicle screws were inserted using the navigation station, in the control group (n = 30) – by the freehand method. The accuracy of pedicle screw position was assessed using postoperative CT images of the spine based on the Gertzbein scale. Results . The total number of pedicle screws inserted in the study group was 1166, in the control group – 546. In the study group, position of screws was correct in 96 % (1119 screws) of observations and incorrect in 4 % (47 screws). In the control group, the correct position was noted only in 78 % (426 screws) of cases, and the number of incorrectly inserted screws was significantly larger – 22 % (120 screws). In the study group, incorrectly inserted screws in the thoracic spine were detected in 4.8 % of cases, in the lumbar spine – in 2.5 %; in the control group, pedicle screws were incorrectly inserted in the thoracic spine in 35.1 % of cases, in the lumbar spine – in 10.1 %. Conclusion . Using the navigation station during surgical intervention aimed at correcting the deformity of the spine in children with idiopathic scoliosis of various locations allows a significant increase in the number of correctly inserted pedicle screws used for instrumentation.