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HighlightsCase of patient with single-stage correction of severe congenital kyphoscoliotic spinal deformities is provided.Combined anterior-posterior approach was applied.Transposition of the spinal cord followed by correction using vertebral instrumentation made it possible to improve trunk balance and stop deformity progression.

A distal level of instrumentation ending at the first lordotic vertebra is not justified and causes violation of sagittal balance and development of distal junctional kyphosis. The inclusion of a sagittal stable vertebra in fusion prevents the development of this undesirable situation.

Introduction: Surgical correction of adolescent idiopathic scoliosis is inevitably accompanied by blood loss. About 37–85% of patients undergo allogeneic transfusions associated with a risk of serious complications. Prediction of the expected blood loss volume remains a topical problem. In this regard, there is a need to clarify predictors of increased blood loss. Aim: To assess the effect of vertebrectomy on the intraoperative blood loss volume during surgical correction of adolescent idiopathic scoliosis. Materials and methods: A retrospective study included 511 adolescents who underwent posterior correction of spinal deformity. Two groups were allocated: Group I consisted of 303 patients who underwent multilevel transpedicular fixation; Group II included 208 patients who underwent multilevel transpedicular fixation combined with Smith-Peterson osteotomy. Results: Intergroup comparisons revealed significant differences in the number of transpedicular fixation levels and the volume of blood loss, which were higher in Group II. After aligning the groups by the number of transpedicular fixation levels using the Propensity Score Matching method, no statistically significant difference was observed. We derived formulas for calculating the expected blood loss volume in Groups I and II. Comparison of the formulas revealed that the formula for Group II predicted a significantly lower volume of blood loss, by 2.51%, while the formula for Group I predicted a significantly higher volume of blood loss, by 3.27%. In our opinion, application of the formula that overestimates expected intraoperative blood loss is most reasonable due to a possibility of the worst case scenario during surgery; therefore, the formula for Group I approaches a universal model for use. Conclusion: Smith-Peterson osteotomy did not affect the amount of blood loss during surgical correction of adolescent idiopathic scoliosis, considering the number of transpedicular fixation levels.

Background: The rate of scoliosis in syringomyelia patients ranges from 25 to 74.4%. In turn, syringomyelia occurs in 1.2% to 9.7% of scoliosis patients. Aim: To evaluate outcomes of surgical correction of the scoliotic deformity in syringomyelia patients. Materials and methods: Between 1996 and 2015, 3120 patients with scoliosis of various etiologies were treated at the Clinic for Child and Adolescent Vertebrology of the Novosibirsk Research Institute of Traumatology and Orthopedics. We conducted a retrospective analysis of syringomyelia-associated scoliosis cases that required surgical correction. Results: Syringomyelia was found in 33 patients (1.05%) out of 3120 patients with spinal deformities of various etiologies; in 21 patients (0.9%) with idiopathic scoliosis of 2334 patients. In identifying the neurological deficit, the recommended first step is to perform neurosurgery. Nineteen patients were operated using the CDI, 4 patients underwent correction VEPTR, in 1 case instrumentation could not be established, 9 patients are undergoing treatment in the department of neurosurgery at the moment. Worsening of neurological deficits was not observed in any patient. Conclusion: A comparison of the results of syringomyelia-associated scoliosis correction with the data of other authors was done. The choice of surgery tactics is strictly individual and depends on the size of the cavity. The result of surgical intervention is generally positive and the loss of correction by the end of follow-up is negligible.