Radiographic outcomes over time after endoscopic anterior scoliosis correction: a prospective series of 106 patients.

ABSTRACT

STUDY DESIGN: A prospective, consecutive series of 106 patients receiving endoscopic anterior scoliosis correction. OBJECTIVE: To analyze changes in radiographic parameters and rib hump in the 2 years after surgery. SUMMARY OF BACKGROUND DATA Endoscopic anterior scoliosis correction is a level sparing approach and therefore, it is important to assess the amount of decompensation which occurs after surgery. METHODS: All patients received a single anterior rod and vertebral body screws using a standard compression technique. Cleared disc spaces were packed with either mulched femoral head allograft or rib head/iliac crest autograft. Radiographic parameters (major, instrumented, minor Cobb, T5-T12 kyphosis) and rib hump were measured at 2, 6, 12, and 24 months after surgery. Paired t tests and Wilcoxon signed ranks tests were used to assess the statistical significant of changes between adjacent time intervals. RESULTS: Mean loss of major curve correction from 2 to 24 months after surgery was 4 degrees. Mean loss of rib hump correction was 1.4 degrees. Mean sagittal kyphosis increased from 27 degrees at 2 months to 30.6 degrees at 24 months. Rod fractures and screw-related complications resulted in several degrees less correction than patients without complications, but overall there was no clinically significant decompensation after complications. CONCLUSION: There are small changes in deformity measures after endoscopic anterior scoliosis surgery, which are statistically significant but not clinically significant.