The ability of posture self-correction after scoliosis surgery

Authors:

Andrey A. Pershin, MD, orthopedist, PhD Med.Sci., the chief of 2nd pediatric orthopedic department of Federal Scientific Center of Rehabilitation of the Disabled named after G.A. Albrecht, Bestuzhevskaya street 50, 195067 Saint- Petersburg, Russian Federation.

Alla B. Koganova, MD, senior orthopedic fellow of Federal Scientific Center of Rehabilitation of the Disabled named after G.A. Albrecht, Bestuzhevskaya street 50, 195067 Saint-Petersburg, Russian Federation.

Zoya I. Fedotova, MD, orthopedist, 2nd pediatric orthopedic department of Federal Scientific Center of Rehabilitation of the Disabled named after G.A. Albrecht, Bestuzhevskaya street 50, 195067 Saint-Petersburg, Russian Federation. E-mail: atamankaz@mail.ru; fone +79500164287

In the heading: Original researches

Year: 2019 Volume: 1 Journal number: 1 

Pages: 42-48

Article type: scientific and practical

UDC: 616.711-007.55

DOI: 10.26211/2658-4522-2019-1-1-42-48

Annotation:

Introduction. The ability for self-correction of posture in three planes is recognized by SOSORT experts as an important condition for the conservative treatment of scoliosis. Surgical treatment of scoliosis means that a significant number of vertebral-motion segments are fused, meanwhile the question of how instrumented fusion affects the patient’s ability to change the position of the body is always important for patients and their parents and medical staff.

Aim. To determine the changes in ability of self-correction in three planes after the surgical treatment of scoliosis.

Material and methods. 12 patients (10 girls and 2 boys) aged from 14 to 17 years with scoliosis. All patients underwent surgical treatment – correction of spinal deformity and posterior instrumentеd fusion. The ability of posture self-correction after posterior spinal fusion was evaluated. The trunk surface metric analysis in natural position and self-correction position was performed. We evaluated parameters as follow: PTI – integral posterior trunk index; PTI-F – integral posterior trunk index in frontal plane; PTI-G – integral posterior trunk index in horizontal plane and PTI-S – integral posterior trunk index in sagittal plane. The difference between integral posterior trunk index, integral indexes for each plane in natural and self-correction positions before and after surgical treatment was considered as the ability of posture self-correction.

Results. Before surgery PTI index in the self-correction posture increased on average by 0.05, after surgery – by 0.03 (p≤0.05). Before surgery, PTI-F index in the posture of self-correction decreased on average by 0.04 (improvement), after surgery – by 0.23 (p≤0.05). Before surgery, PTI-G index in the self-correction posture increased on average by 0.004, after surgery – by 0.04 (p≤0.05). Before surgery PTI-S index in the self-correction posture increased on average by 0.5, after surgery – by 0.02 (changes are statistically significant).

Conclusion. Surgical treatment of scoliosis does not significantly limit the mobility of the posture, and, consequently, the patient’s ability to correct themselves in the frontal and horizontal planes; at the same time, it reduces mobility and limits the tendency to a possible deterioration of posture in the sagittal plane. Thus, surgery creates the conditions for harmonious adaptation of the patient’s body to the achieved changes in trunk anatomy.

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