Skip to main content
SpringerLink
Log in

Treatment of severe scoliosis with posterior-only approach arthrodesis and all-pedicle screw instrumentation

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Purpose

Posterior-only approach arthrodesis by all-pedicle screw instrumentation has a correction rate similar to correction obtained by traditional combined anterior/posterior approach surgery and avoids the complications associated with the thoracic approach.

Methods

We treated 25 patients, with a mean age 16.5 years, with severe adolescent idiopathic scoliosis by posterior-only approach using all-screw instrumentation arthrodesis. Mean scoliosis curve in Cobb degrees was 95° Cobb. All cases were treated by the same senior surgeon, by free hand technique, without intraoperative neurophysiologic monitoring and spine navigation aids.

Results

Mean scoliosis curve after surgery was 37° Cobb. Mean follow-up was 4 years. No perioperative complications, curve progression or arthrodesis malunion were reported at the follow-up.

Conclusions

Posterior spinal fusion with pedicle screw-only instrumentation obtains a good and stable correction of severe scoliosis; compared to hybrid instrumentation, it allows a greater coronal correction of the deformity and less correction loss at the follow-up.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Bullmann V, Halm HFH, Schulte T, Lerner T, Weber TP, Liljenqvist UR (2006) Combined anterior and posterior instrumentation in severe and rigid idiopathic scoliosis. Eur Spine J 15:440–448

    Article  PubMed  Google Scholar 

  2. Shufflebarger HL, Grimm JO, Bui V, Thomson JD (1991) Anterior and posterior spinal fusion. Staged versus same day surgery. Spine 16:930–933

    Article  PubMed  CAS  Google Scholar 

  3. Shen J, Qiu G, Wang Y, Zhang Z, Zhao Y (2006) Comparison of 1-stage versus 2-stage anterior and posterior spinal fusion for severe and rigid idiopathic scoliosis—a randomized prospective study. Spine 31:2525–2528

    Article  PubMed  Google Scholar 

  4. Kim YJ, Lenke LG, Bridwell KH, Kim KL, Steger-May K (2005) Pulmonary function in adolescent idiopathic scoliosis relative to the surgical procedure. J Bone Joint Surg Am 87:1534–1541

    Article  PubMed  Google Scholar 

  5. Arlet V (2000) Anterior thoracoscopic spine release in deformity surgery: a meta-analysis and review. Eur Spine J 9:S17–S23

    Article  PubMed  Google Scholar 

  6. Niemeyer T, Freeman BJ, Grevitt MP, Webb JK (2000) Anterior thoracoscopic surgery followed by posterior instrumentation and fusion in spinal deformities. Eur Spine J9:499–504

    Article  Google Scholar 

  7. Newton PO, Marks M, Faro F, Betz R, Clements D, Haher T (2003) Use of video-assisted thoracoscopic surgery to reduce perioperative morbidity in scoliosis surgery. Spine 28:S249–S254

    Article  PubMed  Google Scholar 

  8. Bradford DS, Tribus CB (1997) Vertebral column resection for the treatment of rigid coronal decompensation. Spine 22:1590–1599

    Article  PubMed  CAS  Google Scholar 

  9. Suk SI, Chung ER, Kim JH, Kim SS, Lee JS, Choi WK (2005) Posterior vertebral column resection for severe rigid scoliosis. Spine 30:1682–1687

    Article  PubMed  Google Scholar 

  10. Arlet V, Jiang L, Ouellet J (2004) Is there a need for anterior release for 70°–90° thoracic curves in adolescent scoliosis? Eur Spine J 13:740–745

    Article  PubMed  Google Scholar 

  11. Burton DC, Sarna AA, Asher MA (2005) The treatment of large(>70°) thoracic idiopathic scoliosis curves with posterior instrumentation and arthrodesis: when is anterior release indicated? Spine 30:1979–1984

    Article  PubMed  Google Scholar 

  12. De Giorgi G, Stella G, Becchetti S, Martucci G, Miscioscia D (1999) Cotrel-Duboysset instrumentation for the treatment of severe scoliosis. Eur Spine J 8:8–15

    Article  PubMed  Google Scholar 

  13. Kuklo TR, Lenke LG, O’Brien MF, Lehman RA, Polly DW, Schroeder BS (2005) Accuracy and efficacy of thoracic pedicle screws in curve more than 90°. Spine 20:222–226

    Article  Google Scholar 

  14. Dobbs MB, Lenke LG, Kim YJ, Luhmann SJ, Bridwell KH (2006) Anterior/posterior spinal instrumentation versus posterior instrumentation alone for the treatment of adolescent idiopathic scoliotic curves more than 90°. Spine 31:2386–2391

    Article  PubMed  Google Scholar 

  15. Luhmann SJ, Lenke LG, Kim YJ, Bridwell KH, Schootman M (2005) Thoracic adolescent idiopathic scoliosis curves between 70° and 100°. Is anterior release necessary? Spine 30:2061–2067

    Article  PubMed  Google Scholar 

  16. Lenke LG, Kuklo TR, Ondra S, Polly DW (2008) Rationale behind the current State-of-the-Art treatment of scoliosis (in the pedicle screw era). Spine 33(10):1051–1054

    Article  PubMed  Google Scholar 

  17. Suk S, Kim JH, Kim SS, Lim DJ (2012) Pedicle screw instrumentation in adolescent idiopathic scoliosis (AIS). Eur Spine J 21:13–22

    Article  PubMed  Google Scholar 

  18. Min K, Sduzy C, Farshad M (2013) Posterior correction of thoracic adolescent idiopathic scoliosis with pedicle screw instrumentation: results of 48 patients with minimal 10-year follow up. Eur Spine J 22(2):345–354

    Article  PubMed  Google Scholar 

  19. Di Silvestre M, Bakaloudis G, Lolli F, Vommaro F, Martikos K, Parisini P (2008) Posterior fusion only for thoracic adolescent idiopathic scoliosis of more than 80°: pedicle screws versus hybrid instrumentation. Eur Spine J 17:1336–1349

    Article  PubMed  Google Scholar 

  20. Crostelli M, Mazza O, Mariani M (2012) Free-hand pedicle screws insertion technique in the treatment of 120 consecutive scoliosis cases operated without use of intraoperative neurophysiological monitoring. Eur Spine J 21(Suppl 1):S43–S49

    Article  PubMed  Google Scholar 

  21. Modi HN, Suh SW, Hong JY, Yang JH (2010) Accuracy of thoracic pedicle screw using ideal pedicle entry point in severe scoliosis. Clin Orthop Relat Res 468:1830–1837

    Article  PubMed  Google Scholar 

  22. Kadoury S, Cheriet F, Beausèjour M, Stokes IA, Parent S, Labelle H (2009) A three-dimensional retrospective analysis of the evolution of spinal instrumentation for the correction of adolescent idiopathic scoliosis. Eur Spine J 18:23–37

    Article  PubMed  Google Scholar 

  23. Gang C, Haibo L, Fancai L, Weinshan C, Qixin C (2012) Learning curve of thoracic pedicle screw placement using the free-hand technique in scoliosis: how many screws needed for an apprentice? Eur Spine J 21:1151–1156

    Article  PubMed  Google Scholar 

  24. Sarlak AY, Buluc L, Sarisoy HT, Memisoglu K, Tosun B (2008) Placement of pedicle screws in thoracic idiopathic scoliosis: a magnetic resonance imaging analysis of screw placement relative to structures at risk. Eur Spine J 17:657–662

    Article  PubMed  Google Scholar 

  25. Suk SI, Kim JH, Cho KJ, Kim SS, Lee JJ, Han TY (2007) Is anterior release necessary in severe scoliosis treated by posterior segmental pedicle screw fixation? Eur Spine J 16:1359–1365

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Spine Disease Unit, Bambino Gesù Pediatric Hospital Roma-Palidoro, Via della Torre di Palidoro 1, Palidoro, Rome, Italy

    Marco Crostelli, Osvaldo Mazza, Massimo Mariani & Dario Mascello

Authors
  1. Marco Crostelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Osvaldo Mazza
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Massimo Mariani
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Dario Mascello
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marco Crostelli.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Crostelli, M., Mazza, O., Mariani, M. et al. Treatment of severe scoliosis with posterior-only approach arthrodesis and all-pedicle screw instrumentation. Eur Spine J 22 (Suppl 6), 808–814 (2013). https://doi.org/10.1007/s00586-013-3027-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-013-3027-7

Keywords

Search

Navigation