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Feasibility of Correction With Instrumentation Only in Congenital Scoliosis

Lee, Choon Sung MD, PhD*; Hwang, Chang Ju MD, PhD*; Kim, Dong-Joon MD; Kwon, Joon MD*; Kim, Yung-Tae MD, PhD*; Lee, Mi Young RN*; Yoon, So Jung RN*; Lee, Dong-Ho MD, PhD*

doi: 10.1227/NEU.0000000000000194
Research-Human-Clinical Studies

BACKGROUND: Although effective correction of deformity in congenital scoliosis can often be achieved with instrumentation only and without more invasive techniques such as hemivertebrectomy (HV), reports of the feasibility of correction with instrumentation only (IO) are lacking.

OBJECTIVE: To compare the results of deformity correction using IO vs HV and to examine the feasibility of and indications for correction with IO in patients with congenital scoliosis.

METHODS: Twenty-five patients underwent correction with either IO (n = 14) or HV (n = 11). The 2 patient groups were compared in terms of age at the time of surgery, preoperative magnitude and flexibility of the main curve, correction rates after surgery and at the final follow-up, surgery time, estimated blood loss, and complications.

RESULTS: The 2 groups did not differ significantly in terms of average patient age or curve magnitude, but the correction with the IO group had greater preoperative curve flexibility (37.1%) than the HV group (21.0%). The correction rates immediately after surgery were high in both groups. The correction with IO group had a shorter mean operation time (308 minutes vs 366 minutes) and less blood loss (540 mL vs 1547 mL) than the HV group.

CONCLUSION: Satisfactory correction of congenital scoliosis can be obtained with IO if there is adequate flexibility in the main curve, thus avoiding the need for more invasive procedures such as HV.

ABBREVIATIONS: HV, hemivertebrectomy

IO, instrumentation only

*Scoliosis Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea;

Department of Orthopaedic Surgery, Bumin Hospital, Busan, Korea

Correspondence: Chang Ju Hwang, MD, PhD, Scoliosis Center, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, Korea. E-mail:

Received August 30, 2012

Accepted September 25, 2013

Copyright © by the Congress of Neurological Surgeons