[Operative treatment of severe spine deformities]

87 patients with scoliosis, 32 cases with kyphosis of a various etiology were operated. Patients with severe scoliotic deformations (the total angle 75-140 [Russian character: see text]) got 2 types of the treatment. The first group consisted of 18 patients who were operated in two-stage surgery during the same anesthesia. In the second group (69 patients) after anterior diskectomy within 10-20 days preliminary correction of deformation with halo-pelvic traction was carried out followed by main stage of operation the final dorsal correction of deformation with Cotrel-Dubousset instruments. A significant (more than 40%) correction of deformation was achieved in both groups. However in the 2nd group the value of main angle exceeded 90 [Russian character: see text]. There were operated 32 patients with severe kyphotic deformities. Out of them 15 patients had severe posttraumatic vertebral kyphotic deformations (dislocation fractures of III-IV type according to Denis classification), 11 cases had--postlaminectomy kyphoses, 6 patients suffered from Scheuermann-Mau's disease. The patients with dislocation-fractures underwent laminectomy, reposition of dislocation, and transpedicular fixation of the vertebral column. In 14 patients dislocation was reduced completely, in the one case partially, but in all cases stable spondylosyndesis was achieved. In 8 patients dislocation-fractures were complicated by paraplegia or rough paraparesis), the 3 cases showed practically entire regress after operation, in the 5 cases no evident improvement in the neurologic status occurred. Patients with postlaminectomy kyphoses were treated with wedge vertebrotomy at the top of a curve, dorsal correction and fixation of the vertebral column with CDI system. In the 4 cases there was noted significant improvement in the neurologic status. Patients with Scheuermann-Mau's kyphosis were treated with anterior multilevel diskectomy, followed by halo-pelvic traction, and later dorsal correction of deformation with CDI system. Treatment resulted in significant correction of deformation was achieved and physiological or close to physiological sagittal profile of spine was restored.