CORRELATION BETWEEN THE RATE OF DECOMPENSATION IN SPINAL MEMBRANE BLOOD CIRCULATION, THE MAGNITUDE OF SPINAL DEFORMITY AND THE OUTCOMES OF SURGICAL TREATMENT IN PATIENTS WITH IDIOPATHIC SCOLIOSIS

Objective. To study microcirculation in spinal membranes, and its correlation with the magnitude of spinal deformity and the outcomes of surgical treatment in patients with grade III–IV idiopathic scoliosis. Material and Methods. Intraoperative laser Doppler flowmetry was performed to measure microcirculation in spinal membranes at the deformity apex and adjacent segments during surgical correction of scoliosis in 10 patients at the age of 14 to 17 years. Results. It was revealed that the volumetric capillary blood flow in spinal membranes at the deformity apex was decreased by 27–57 % as compared to sufficient level. Decompensation of microcirculation in membranes was more expressed in Sshaped deformity. Blood flow reduction is in direct relation to the angle of spine deformity. Spine deformity correction with intraoperative distraction measuring from 5 to 20 mm could cause neurologic complications if blood flow in spinal membranes at the apex of deformity is less than 20ml/min per 100 g and cranial blood flow ranges from 18 to 40 ml/min per 100 g. These patients should be treated with a more sparing intraoperative distraction of the spine (≤5 mm) followed by conservative enhancement of spinal cord microcirculation. Conclusion. Parameters of volumetric capillary blood flow in spinal membranes at the deformity apex and adjacent segments could be used for prediction of neurological complications in surgical correction of idiopathic scoliosis.