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Objective. To analyze results of final surgical treatment for scoliosis in the first decade of life. Material and Methods. In 2008–2016, a total of 95 patients with infantile and juvenile scoliosis were operated on using VEPTR instrumentation. The final stage of surgical treatment was performed in 14 patients (9 girls, 5 boys). The average age at the start of treatment was 5.4 ± 2.1 years, average follow-up period – 2 years (6–36 months). Results. Average value of the primary scoliotic curve before surgery was 83.0° ± 14.8°, thoracic kyphosis 41.1° ± 11.9°, lumbar lordosis 49.5° ± 4.9°. At the last follow-up average value of the primary scoliotic curve was reduced to 56.8° ± 14.1°, thoracic kyphosis to 24.5° ± 8.5°, lumbar lordosis to 38.4° ± 5.1° (p < 0.05). Space available for lung before surgery was 84.5 ± 8.7 %, after surgery 94.8 ± 6.7 %, at the last follow-up it increased to 98.6 ± 5.4 %. Complications included 9 cases of instability of implant anchors and 1 case of suppuration. There were no neurological complications. Conclusion. Stage correction using different instrumentations is a method of choice for surgical treatment of infantile and juvenile scoliosis.

Objective. To analyze the outcomes of surgery for congenital kyphotic deformities of the spine in patients over 10 years old. Material and Methods. A total of 49 patients with congenital kyphosis were operated on. The age of the patients at the time of treatment was at least 10 years (mean 14.8 years), the follow-up period – at least 2 years (mean 3.8 years). All patients were operated on using third generation segmental instrumentation with hook and hybrid fixation. Results. Congenital kyphotic deformities are of high rigidity. The average magnitude of preoperative kyphosis was 92.9°, mobility – 27.5 %, during the operation it was corrected to 61.7° (33.5 %), postoperative progression was 4°. All anthropometric indicators have improved, the SRS-24 survey also showed positive patient-reported outcomes. At the same time, the complications are quite frequent, as well as initial involvement of the spinal canal content in the pathological process (11 patients). Conclusion. Congenital kyphotic deformities should be detected as early as possible and timely treated.

The article describes an approach for early diagnosis and treatment of idiopathic scoliosis adopted at the Novosibirsk Re- search Institute of Traumatology and Orthopedics (NRITO). Idiopathic scoliosis is a genetically determined disease. Screening examinations of children and adolescents are required for early diagnosis of the disease. The most effective con- servative treatment is brace therapy. Surgical treatment is strictly differentiated depending on the patient age. Multi-stage treatment by means of VEPTR instrumentation has been used in patients of the first decade of life. One-stage surgery us- ing transpedicular fixation throughout the curve has been performed in patients aged 11–13 years. One- or two-stage sur- gery, depending on the curve mobility, has been used in patients aged 14–20 years. Deformities of more than 90° require a multistage intervention with anterior and posterior spinal mobilization.