Ponte osteotomy followed by sequential correction technique with satellite rods in severe rigid thoracic scoliosis / 中华骨科杂志

ABSTRACT

Objective@#To investigate the efficacy and safety of Ponte osteotomy and sequential correction technique with satellite rod construction in the treatment of severe rigid thoracic scoliosis.@*Methods@#A total of 32 patients (12 male, 20 female) with severe rigid thoracic scoliosis (Cobb angle>100°) who underwent posterior Ponte osteotomy and sequential correction technique with satellite rod construction between October 2012 and October 2016 and with more than 2 years follow-up were retrospectively reviewed. Major curve Cobb angle, apex vertebral translation, trunk shift, thoracic kyphosis and lumbar lordosis were measured through standing posterior-anterior X-ray preoperatively, postoperatively and at the final follow-up. The duration of operation, blood loss and complications were recorded. SRS-22 questionnaire was used to evaluate the clinical outcomes.@*Results@#The average age was 21.3±10.8 years (range from 17 to 46 years). The mean preoperative major curve Cobb angle was 117.8°±9.8°(range from 104° to 131°) with a mean flexibility of 13.9% and the mean thoracic kyphosis was 65.5°±18.7° (range from 48° to 87°). The mean duration of operation was 267.4±42.3 min and the mean blood loss was 895.4±103.1 ml. The mean fused levels ranged from T2 to L4 with a mean 13.3±2.4 fused segments. The mean implant density was 62.1%±8.8%. Ponte osteotomy was performed in 4-9 segments which was 6.1±1.9 segments in average. The coronal main curve was corrected to 54.4°±10.9° with a mean correction rate of 53.9%±9.3% and the mean thoracic kyphosis was corrected to 35.6°±12.0°, which were both significantly improved. The average follow-up time was 34.3±8.9 months. At the last follow-up, the mean coronal main curve was 53.1°±1.9° with a mean correction loss of 1.3° and the thoracic kyphosis was 36.7°±11.4°. There were no neurological deficit or implant failure postoperatively and follow-up.@*Conclusion@#Ponte osteotomy followed by sequential correction technique with satellite rods construction was safe and effective which could achieve satisfactory correction rate and less correction loss during the longitudinal follow-up in the treatment of severe rigid thoracic scoliosis.