Anterior spinal fusion for management of adolescent idiopathic scoliosis

ABSTRACT

Segmental instrumentation is the current standard surgical treatment for severe adolescent idiopathic scoliosis [AIS]. Twenty-one patients with AIS operated through anterior release, fusion and instrumentation were reviewed. The preoperative scoliotic curve pattern, severity, and flexibility were assessed and sagittal thoracic kyphosis and lumbar lordosis were measured. The correction gained after operative procedure was evaluated and compared with the literature. Special concern was given to the effect of surgery on spontaneous correction of the secondary curves, trunk decompensation and changes in the sagittal alignment. The reported complications until solid fusion were collected, analysed and discussed. Anterior spinal fusion achieved correction of the main scoliotic curve at latest follow-up by 76% in average and improved spinal decompensation in 6 out of 7 patients. It improved the secondary proximal [PC] and distal curves at the latest follow-up by mean values of 8° and 20° respectively. The reported complications were one case of asymptomatic pseudarthrosis, one residual partial trunk imbalance and one partial pull-out of the proximal vertebral fixation. Anterior spinal fusion is one of the current surgical options. It has certain advantages over the standard posterior approach in short-term studies. However, long-term follow-up studies are still required