Features:

– Even at Grade III deformity, significant degenerative changes are observed, such as:
pain syndrome with functional limitations, myeloischemia, and myelogenic intermittent claudication, which leads to early disability of the patient.
– Conservative treatment is generally ineffective, which underscores the importance of surgical intervention.
– Surgical treatment is challenging due to the severity of degenerative-dystrophic changes.
– There is no universally accepted surgical treatment algorithm.

Progression of dysplastic left-sided lumbar scoliosis.

1962 – 16 years old1984 – 38 years old

Surgical treatment of lumbar scoliosis aims to achieve the following goals:

  • Relief of clinical and neurological symptoms of the disease
  • Correction of spinal deformity and restoration of anatomical relationships in the lumbar region
  • Prevention of further progression of the deformity

According to these goals, surgical treatment involves:

  • Adequate decompression of the spinal canal and nerve structures
  • Stable fixation and correction of the lumbar spine using modern metal constructs
  • Creation of posterior and interbody spinal fusion (spondylodesis)
  • Restoration of the height of the intervertebral space and foraminal openings

Indications for surgery:

  • Persistent lumbar pain (lumbalgia), lumbar sciatic pain (lumboischialgia) that does not respond to conservative treatment
  • Myelogenic intermittent claudication

Clinical case:
Patient, 13 years old. Lumbar scoliosis, Grade III. Degenerative-dystrophic changes in the lumbar spine. Myeloischemia, symptoms of intermittent claudication.

Before surgery: 35°
Combined spinal canal stenosis due to protrusion and thickening of the ligamentum flavum.

After surgery:
Operation included:

  • Mobilization of the deformity using the Shulutko method
  • Partial facetectomy
  • Deformity correction and fixation with a transpedicular frame system
  • Autospinal fusion (autospodylodesis)

After surgery:
100% correction of the deformity.
Pain syndrome and neurological symptoms regressed.