METHOD FOR SURGICAL CORRECTION OF SCOLIOTIC SPINAL DEFORMITY OF PATIENTS Russian patent published in 2021 - IPC A61B17/70 A61B6/03 A61B34/10 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to traumatology and orthopedics, and can be used for the surgical correction of a scoliotically deformed spine. In the preoperative period, the spatial visualization of the affected bone anatomical structures of the reconstructed spine of the patient is determined by the method of multilayer spiral computed tomography. The state of the surrounding soft tissues, vascular and nervous structures is assessed by the method of magnetic resonance imaging. The results of multilayer spiral computed tomography of the anatomical structural features of the scoliotically deformed spine of the patient are saved in DICOM format and transferred to Dolphin Imaging with the formation of DICOM files. Formation of a solid STL demo 3D model of the spine with display of all affected bone anatomical structures and anomalies of the spine from a biocompatible and non-toxic polymer material is performed, which is acrylonitrile butadiene styrene (ABS), or polyethylene terephthalate with glycol (PET-G), or polylactide (PLA), or polyamide. Virtual planning of the stages of surgical correction of the scoliotically deformed spine of the patient with virtual determination of the points of insertion of the pedicle screws for metal fixation in the process of the forthcoming correction of scoliotic deformity is performed using the manufactured demonstration 3D model of the spine. Metal rods with a diameter of 2.0-3.0 mm and a length of 80 to 150 mm are placed at the specified points of insertion of the pedicle screws, with their subsequent use as visual and control information during the surgical correction of the scoliotically deformed spine. The manufactured 3D model of the spine with the rods installed on it is subjected to gas sterilization treatment. With the patient in the prone position, after the implementation of anesthesia, an incision of the skin over the spinous processes of the spine is performed one level above and below the intended area of ​​installation of the metal structure, followed by dissection of the subcutaneous tissue and its own fascia. Skeletonization of the posterior elements of the spine is performed on both sides, transpedicular screws are placed on the concave side of the scoliotic deformity under the control of the image intensifier with visual use of the previously made 3D model of the patient's spine with the given points of placement and the angle of insertion of the pedicle screws of the scoliotic deformity metal construction. A metal fixation rod of metal fixation, curved along thoracic kefosis and lumbar lordosis of scoliotic deformity, is placed on the heads of the placed transpedicular screws, followed by its fixation with nuts. A derotation maneuver is performed by rotating the metal fixing rod to the concave side. The transpedicular screws are placed on the convex side of the skeletal spine and a metal fixing rod is fixed in them. Posterior fusion and layered suturing of dissected muscles and fascia of the postoperative wound are performed.

EFFECT: method provides a reliable anatomical restoration of the shape and support function of the spine, obtaining a full posterior spinal fusion with restoration of the configuration of the spinal canal, early social rehabilitation of the patient due to the positioning of the transpedicular screws.

1 cl, 4 ex