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Short Segment Anterior Correction of Moderate Single Primary Curve Adolescent Idiopathic Scoliosis: Our Two to 12 Year Experience (Mean Follow‐Up Six Years): Paper #2

Mehta, Jwalant S. FRCS, MCh, MS (Columbia Orthopaedic Group); Kusakabe, Takashi MD; Gaines, Robert W. MD

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Spine Journal Meeting Abstracts: September 2009 - Volume 10 - Issue - p 53–54
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Introduction: Our short segment anterior technique produces similar results and outcomes for AIS patients with fewer levels fused than posterior segmental instrumentation. We present the results of the first consecutive 45 patients operated by the short segment bone‐on‐bone anterior scoliosis technique with a mean follow‐up of 6 years.

Methods: The patients (28 thoracic; 17 thoracolumbar) were operated between 1996 and 2004 for single curve idiopathic scoliosis. The mean age was 19 yrs (9 ‐ 51); 87 % were females and the mean follow‐up was 72 months (range 28 ‐ 121 months). The short segment anterior approach comprised of “total discectomy”, bone‐on‐bone apposition and dual‐rod instrumentation. We assessed the sagittal and coronal corrections on radiographs performed pre‐operatively, post‐operatively and at the final follow‐up.

Results: A mean of 5 vertebrae (4 discs) were instrumented. The mean operative time 360 min, blood loss 877 ml and hospital stay 9.1 days. The thoraco‐lumbar major curve was 50.5° (pre‐op) and 18.3° (final). (A, B) The lower tilt angle was 27.7° (pre‐op) and 8.3° (final). The main thoracic curve was 52.5° (pre‐op) and 27.9° (final).(C, D)The lower tilt angle was 20.9° (pre‐op) and 11° (final). Spontaneous improvement in the compenstaory curves of 37.4% (thoracic) and 47.5% (thoracolumbar). The sagittal and coronal balance was restored in all the patients. There was no loss of correction in the operated segment. There were no infections, or neurological, vascular, pulmonary or implant‐related complications. Union occurred in all the patients in 2–4 months. All the patients were back to an un‐restricted lifestyle within 4 months.

Conclusion: Our short segment bone‐on‐bone technique produces excellent, predictable correction of primary single curve adolescent idiopathic scoliosis with no loss of correction at mean 6 yrs follow‐up.

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Significance: When treating single major curves of AIS < 75° the short segment approach produces good clinical and radiological results with no loss of correction at 6 years. Every patient was followed over 2 years and none was lost to follow‐up. This is achieved by instrumenting 5 vertebrae and 4 discs for patients with curves of 75 degrees or less.

© 2009 Lippincott Williams & Wilkins, Inc.