Characteristics of surgical treatment of patients with comorbidities in scoliotic disease

A large number of studies deal with the study of the etiology and pathogenesis of scoliotic disease, since it is the most common disease among all the pathologies of the supporting-motor system. Scoliosis is more common in patients aged 4 to 17. Its frequency in the adult population reaches 18.2 cases per 1000 of population. The developed and widely applicable non-surgical therapy of moderate, progressive, and severe extent of disease do not always lead to positive outcomes. A variety of surgical methods for treating scoliosis is successfully used nowadays. Modern types of fixing hardware, including two-leg growing systems, most often used in practice, allow simultaneous correction of vertebral deformity in three planes and reliably stabilize the spinal column in a position closest to the physiological one. Since most organs and systems of the body are affected by scoliosis, it is necessary to take into account the characteristics of the comorbid background of patients for successful surgical treatment and effective postoperative rehabilitation. Comorbidity creates special requirements for surgical and rehabilitation approach to achieve biomechanically correct fitting of the structure and its rigid fixation on the supporting osseous structures.

The aim of the study was to identify the most common comorbidities in patients with scoliosis admitted for surgical treatment, to highlight the features of surgical treatment and rehabilitation of these groups of patients.

Material and methods. We studied 118 case histories of patients admitted for surgical treatment of scoliosis, monitoring characteristics of the periods of treatment and rehabilitation after surgical correction of vertebral deformity.

Results. Degenerative vertebral diseases, cardiovascular development abnormalities and diseases of the gastrointestinal tract were noted with the highest frequency as diseases associated with scoliosis. The characteristics of surgical approach in the correction of vertebral deformity depending on the identified comorbidity are generalized.

Conclusions. The revealed comorbidity pattern indicates the fundamental generality of the etiology of scoliosis and these diseases, as well as the pathogenetic role of vertebral deformities in the development of a number of diseases. This fact must be taken into account when planning approaches to surgical interference and individual rehabilitation program in the early postoperative period.

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