Treatment of adolescent idiopathic scoliosis with posterior simultaneous correction by bilateral corrective rod on the convex and concave sides / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the efficacy and clinical value of the strategy of posterior simultaneous correction by bilateral corrective rod on the convex and concave sides in the treatment of adolescent idiopathic scoliosis (AIS).</p><p><b>METHODS</b>From February 2006 to August 2008, posterior fusion was performed to 48 AIS patients. There were 16 males and 32 females, with an average age at the time of surgery of 17.1 years. Lenke Type I was found in 17 cases, Type II in 9, Type III in 14 and Type IV in 8. There were 27 patients used selective posterior fusion in thoracic, 21 cases without selective fusion. Observation index the Cobb angle on coronal plane, translation and rotation of apical vertebrae, the coronal balance, the Cobb angle on sagittal plane, obliquity between lowest instrumented vertebrae (LIV) and the pelvis, intervertebral angle and rotation of the LIV. The patients were followed up at an average time of 15.1 months (12-27 months).</p><p><b>RESULTS</b>In the 27 cases with selective fusion, thoracic coronal Cobb angle was (17 + or - 8) degrees after the operation, with an average correction rate of (76 + or - 11)% at final follow up. The lumbar Cobb angle was (13 + or - 7) degrees after the operation, with an average correction rate of (72 + or - 9)% at final follow up. In the 21 cases without selective fusion, the thoracic Cobb angle was (20 + or - 7) degrees after the operation, with an average correction rate of (74 + or - 15)% at final follow up. The lumbar Cobb angle was (16 + or - 8) degrees after the operation, with an average correction rate of (69 + or - 9)% at final follow up. The average number of vertebrae retained below LIV was 4.4. There was 1 case developing thoracolumbar kyphosis. During the follow up, there were no major complication of neurological injury, no pseudarthrosis and no spine decompensation.</p><p><b>CONCLUSION</b>Posterior bilateral segmental pedicle screw simultaneous correction technique as a technique for correcting thoracic and lumbar curves scoliosis can improve the treatment of idiopathic scoliosis with fewer vertebral fusion and complications.</p>