Document Detail


Does wide posterior multiple level release improve the correction of adolescent idiopathic scoliosis curves?
MedLine Citation:
PMID:  20075750     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY DESIGN: Retrospective matched cohort study.
OBJECTIVE: To compare results of posterior correction and fusion with a hybrid construct using a standard posterior release (SPR) versus adding a wide posterior release (WPR), in adolescent idiopathic scoliosis (AIS) treated at a single institution, with a minimum 2-year follow-up.
SUMMARY OF BACKGROUND DATA: Although the importance of posterior release has been enhanced for the correction of AIS, there have been no reports comparing correction results when posterior wide release (excision of all posterior ligaments and bilateral extended facetectomy at multiple levels) is used.
METHODS: A retrospective study of 46 patients with AIS was performed. Posterior-only hybrid instrumentation with sublaminar wires was included. SPR group consisted of 25 patients and WPR group consisted of 21 patients.
RESULTS: There was no difference in sex, age, type of curve, number of instrumented levels, length of surgery, and preoperative main curve Cobb (SPR: 60±10 degrees WPR: 59±8 degrees). In the WPR group, the amount of main curve correction obtained was significantly greater (SPR: 57% vs. WPR: 68.6%) P<0.001, and maintained at final follow-up (SPR: 51.6% vs. WPR: 61.8%) P<0.05. Preoperative and postoperative proximal thoracic and lumbar secondary curves were similar in both the groups. T5-T12 preoperative kyphosis were (SPR: 22.2±11 degrees vs. WPR: 19±11 degrees) the degrees corrected in postoperation (SPR: +1.2±6 degrees vs. WPR: -0.9±9 degrees) and at final follow-up (SPR: +1.6±8 degrees vs. WPR: -0.8±11 degrees), and were not statistically different P>0.05. Minor complications were similar in both groups and no major complications were found.
CONCLUSIONS: Posterior wide release at multiple levels improves coronal main curve correction in patients with AIS, without an increase in the incidence of complications. Furthermore, it improves fusion surface and makes insertion of sublaminar wires easier.
Authors:
Javier Pizones; Enrique Izquierdo; Felisa Sánchez-Mariscal; Patricia Alvarez; Lorenzo Zúñiga; Alejandro Gómez
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of spinal disorders & techniques     Volume:  23     ISSN:  1539-2465     ISO Abbreviation:  J Spinal Disord Tech     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-05     Completed Date:  2011-01-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101140323     Medline TA:  J Spinal Disord Tech     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e24-30     Citation Subset:  IM    
Affiliation:
Spine Unit, Department of Orthopaedic Surgery, Hospital Universitario de Getafe, Madrid, Spain. javier.pizones@wanadoo.es
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Bone Screws
Humans
Retrospective Studies
Scoliosis / radiography,  surgery*
Spinal Fusion / instrumentation,  methods*
Spine / radiography,  surgery*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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