METHOD OF SURGICAL TREATMENT OF IDIOPATHIC SCOLIOSIS OF THE SPINE USING THE COMBINED INTRODUCTION OF TRANSPEDICULAR SCREWS Russian patent published in 2023 - IPC A61B17/70 A61B6/03 A61B34/10 

FIELD: medicine; traumatology; orthopedics.

SUBSTANCE: invention can be used for surgical treatment of idiopathic scoliosis of the spine using the combined introduction of pedicle screws and can be used for the treatment of patients with spinal deformities in trauma, surgical and other hospitals. In the preoperative period, the spatial visualization of the affected bone anatomical structures of the reconstructed patient's spine 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. Research results are saved in DICOM format and transferred to Dolphin Imaging to form DICOM files. The formation of a solid-state STL demonstration 3D model of the spine is performed with the display of all affected bone anatomical structures and anomalies of the spine from a biologically compatible and non-toxic polymer material, which is ABS acrylonitrile butadiene styrene, or polyethylene terephthalate with PET-G glycol, or polylactide PLA. The virtual planning of the stages of surgical correction of the patient's scoliotically deformed spine with the virtual determination of the points of insertion of pedicle fixation screws into it in the process of the upcoming correction of idiopathic scoliotic curvature is performed using the made demonstration 3D model of the spine. After the implementation of anesthesia with the patient in the prone position, an incision of the skin over the spinous processes of the vertebrae is performed one level above and below the intended area for the installation of the metal structure in the vertebra, followed by dissection of the subcutaneous tissue and its own fascia with access to the spine. The implantation of pedicle screws is performed, while channels are prepared for placement of pedicle screws using the “free-hand” technique. The cortical plate is perforated with an awl in the area of the arch root projection. The formation of the primary hole is carried out, palpation is performed with a filler to determine the length of the transpedicular screws. Threading is performed for pedicle screws using a tap and pedicle screws are inserted into the formed holes. Intraoperatively, using an image intensifier tube, the control of the correct location of the pedicle screws is performed with a clear use of a previously made 3D model of the patient's spine. A metal fixing rod for metal fixation is placed on the heads of the installed pedicle screws from the concave side of the spine, followed by its fixation with nuts. Mechanical pressure is applied to the top of the deformation. Derotation is performed using a metal fixing rod of metal fixation placed on the heads of the installed pedicle screws from the convex side of the spine. Layer-by-layer suturing of the dissected muscles and fascia of the postoperative wound is performed.

EFFECT: method provides reliable anatomical restoration of the shape and supporting function of the spine, obtaining a full-fledged posterior fusion with restoration of the configuration of the spinal canal, as well as early social rehabilitation of the patient with sufficient and necessary improvement in the quality of his life due to the peculiarities of the method.

1 cl, 3 ex