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Dual Sequential Short Anterior Correction in Double Major Adolescent Idiopathic Scoliosis

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Abstract

Study Design

retrospective comparative study.

Introduction

The standard surgical technique for double major adolescent idiopathic scoliosis (AIS) has been the fusion of both thoracic and thoracolumbar/lumbar curves from the posterior approach. Although short anterior correction is established in AIS with single thoracic or thoracolumbar/lumbar curves, anterior correction in double major curves has not yet been described. The purpose of this study is to compare this novel technique with standard posterior pedicle screw instrumentation in double major AIS.

Methods

19 consecutive patients with a double major AIS were treated surgically either with pedicle screw instrumentation and posterior fusion (n = 11) or dual anterior short instrumentation and fusion (n = 8) of both curves. The mean follow-up was 5.6 ± 3 years (2–10 years). Clinical and radiologic results, results of pulmonary function, and Scoliosis Research Society (SRS) questionnaire are analyzed and compared.

Results

The length of fusion was 7.6 ± 0.7 vertebrae with the anterior technique and 12 ± 1 vertebrae with the posterior technique (p < .001). Cobb angle correction was 78% and 53% in thoracic curves, and 80% and 59% in lumbar curves with posterior and anterior technique respectively (p < .05). The preoperative pulmonary function remained unchanged to the last follow-up in both groups. The scores of SRS-24 questionnaire were similar preoperatively and at the last follow-up in both groups.

Conclusion

This novel technique of dual sequential short anterior correction is an alternative to the standard posterior long fusions in the double major AIS. A significantly less amount of mobile segments needs to be fused leaving the thoracolumbar junction mobile and saving at least one lumbar mobile segment distally.

Level of Evidence

Level III.

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Authors and Affiliations

  1. Departement of Orthopaedics, Balgrist University Hospital, University of Zurich, Forchstrasse 340, Zurich, 8008, Switzerland

    Kan Min MD, Lukas Jud MD & Mazda Farshad MD, MPH

Authors
  1. Kan Min MD
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  2. Lukas Jud MD
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  3. Mazda Farshad MD, MPH
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Corresponding author

Correspondence to Kan Min MD.

Additional information

Author disclosures: KM (none), LJ (none), MF (none).

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Min, K., Jud, L. & Farshad, M. Dual Sequential Short Anterior Correction in Double Major Adolescent Idiopathic Scoliosis. Spine Deform 6, 545–551 (2018). https://doi.org/10.1016/j.jspd.2018.01.009

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  • DOI: https://doi.org/10.1016/j.jspd.2018.01.009

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