The Use of Short and Rigid Anterior Instrumentation in the Treatment of Idiopathic Thoracolumbar Scoliosis

Bitan, Fabien D.; Neuwirth, Michael G.; Kuflik, Paul; Casden, Andrew M.; Bloom, Norman D.; Siddiqui, Sid

doi:10.1097/00007632-200207150-00014

Cited by 35 publications

(30 citation statements)

References 9 publications

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“…Intervertebral body fusion shows higher fusion rate than posterior fusion 14) . During short segment fusion hyperkyphosis can be prevented by derotation of the bent rod 2 . In our series, we used only 5-7 vertebral body fixations to get an acceptable major curve correction.…”

Section: Discussionmentioning

confidence: 99%

Short Segment Anterior Correction of Adolescent Idiopathic Scoliosis

Han

Chin

2008

J Korean Neurosurg Soc

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Section: Discussionmentioning

confidence: 99%

Short Segment Anterior Correction of Adolescent Idiopathic Scoliosis

Han

Chin

2008

J Korean Neurosurg Soc

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“…The surgeons who prefer the use of short constructs in line with J. Hall [5,6,19,23] recommend that an over-correction should be made at the apex of the curvature, usually including three vertebrae, using the bone-on-bone technique: no long-term follow-up results are yet available on this procedure. Were there any cases in which the construct should have been longer?…”

Section: S158mentioning

confidence: 99%

Anterior instrumentation (dual screws single rod system) for the surgical treatment of idiopathic scoliosis in the lumbar area: a prospective study on 33 adolescents and young adults, based on a new system of classification

Bergoin¹

2012

Eur Spine J

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Objectives/purpose The choice of anterior instrumentation in the treatment of lumbar scoliosis in adolescents and young adults is not a new topic for the authors. The first results achieved using the Dwyer surgical modality were reported by one of the authors followed by the results achieved using Zielke (VDS) instrumentation. Today, new techniques and new instrumentations have been developed that challenge the instrumentation choices. Here we describe how the new system of classification of scoliotic curves we developed has been used as a basis for treating idiopathic scoliosis in lumbar area in adolescents and young adults using an anterior approach. Materials A prospective study was carried out between 1998 and 2010 at two hospital centers on 33 adolescents and young adult with idiopathic lumbar scoliosis involving curves of three kinds, on whom surgical treatment was performed using a single solid rod. Topography of curves: our system of classification includes curves corresponding to the following three type of scoliosis: Type K I: double thoracic and lumbar curves (lumbar predominant) scoliosis (17 cases) mean age 16 years all female patients. Mean Cobb angle of lumbar curve 41°. Mean Cobb angle of thoracic curve 28°. The lumbar curve was left hand convex in 15 cases and right hand convex in 2 cases. Horizontal tilting of L4 mean value 22°. C7 offset mean value 3 cm. Type K IV A: unbalanced thoracolumbar scoliosis (13 cases) mean age 17 years, ten female patients and three male patients. Mean Cobb angle of thoracolumbar curve 39°. The thoracolumbar curve was left hand convex 4 times and right hand convex 9 times. Horizontal tilting of L4 mean value 18°. C 7 offset mean value 2.5 cm. Type K VI A: real lumbar (three cases). Age: 17, 15 and 13 years; all female patients. Cobb angle of the lumbar curve 66°, 29°a nd 70°(all LH convex). Horizontal tilting of L4: 40°, 20°a nd 46°. C 7 offset: 7 cm, 1 cm and 4 cm. 123Eur Spine J (2013) 22 (Suppl 2):S149-S163 DOI 10.1007/s00586-012-2343-7 failure: there were three cases of screw breakage, all occurred on the lowest implant. Revision surgery was undertaken in both cases, only the last plate needed to be replaced and the rod could be kept without any other modification of the construct. In both cases, fusion has been achieved without any loss of correction. The mean loss of correction of the main curve was 2.5°for the three series. Conclusions Anterior instrumentation of lumbar idiopathic scoliosis gives highly satisfactory morphological and functional results, since the lumbar musculature is spared and the instrumentation placed at the apex of the curvature has selective effects. Despite our preference and that of other surgeons throughout the world for anterior instrumentation, we are still a minority in comparison with the users of posterior instrumentation. There are several reasons for this reticence, including surgeons' training and ideas about pedicular screw fixation, but the main reason has been the lack of a sufficiently exact system of classificat...

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“…Recently, anterior spine fusion for correction of adolescent idiopathic scoliosis has gained popularity [3,4]. The advantages of anterior spine fusion over posterior fusion could be shorter fusion [3,4], better correction of hypokyphosis and possible better cosmetic outcome.…”

Section: Introductionmentioning

confidence: 99%

“…The advantages of anterior spine fusion over posterior fusion could be shorter fusion [3,4], better correction of hypokyphosis and possible better cosmetic outcome.…”

Section: Introductionmentioning

confidence: 99%