Posterior Correction of Adolescent Idiopathic Scoliosis (AIS)

Abstract

Operative correction of AIS has evolved tremendously over the last decades trending in the favored use of posterior correction by means of all-pedicle-screw-constructs, stiffer rods, higher screw density, and last but not least intraoperative neuromonitoring (IONM) substantially supporting intraoperative distraction and de-rotation of the deformed spine rendering highly effective correction. A satisfactory correction of AIS is favored by the use of fixed angle screws (FAS) versus multiaxial screws (MAS), due to the fact of unsurpassed stability of FAS in comparison to all other pedicle screw designs. The use of FAS, whenever possible, may address more effectively correction of the deformity both in the coronal plane by transporting FAS on stiff rods in a controlled manner leading to a relatively elongation of the posterior spine, as well as in the sagittal plane by allowing to introduce superior forces on the screws with less deterioration of the screw stability in order to perform consequent spine de-rotation with a modified DVR procedure removing the AIS pathognomonic hunchback.