Surgical results of one stage anterior release and posterior correction for treatment of severe scoliosis
- VernacularTitle:一期前路松解后路三维矫形治疗重度僵硬性脊柱侧凸
- Author:
Ming LI
;
Yang LIU
;
Xiaodong ZHU
- Publication Type:Journal Article
- Keywords:
Scoliosis;
Spinal fusion;
Internal fixators
- From:
Chinese Journal of Orthopaedics
2001;0(05):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To present the surgical results of severe scoliosis treated with one stage anterior release and posterior instrumentation. Methods 36 patients of severe scoliosis received one stage anterior release and posterior correction during July 1997 to January 2003. There were 9 males and 27 females with an average age of 17.2 years, including 33 idiopathic scoliosis and 3 neurofibromatosis scoliosis. The Cobb's angles of scoliosis were from 85? to 116? with a mean of 96.2?. 18 cases were found with single thoracic curve, 7 cases double thoracic and lumbar curves, 6 cases thoracolumbar curve, 4 cases lumbar curve, and 1 case double thoracic and lumbar curves with associated lumbar curve. 20 cases had abnormal sagittal profile. Three-dimensional instrumentations such as CD (4 cases), CD-Horizon (5 cases), TSRH (10 cases) or Isola (17 cases) were used in posterior procedure after anterior release under the same anesthesia. 31 cases of this group received thoracoplasty. Results The coronal correction was achieved 48.5% on average. The sagittal profile of the spine was distinctly ameliorated. The sagittal balance was restored or maintained in 80.6% of the patients. There were no severe neurological complications, hook displacement, rod breaking and deep infection at follow-up. One case of traumatic pleurisy occurred after surgery and one pseudarthrosis at 2 years later. One patient demonstrated imbalance 11 months after surgery. Two patients presented loss of correction more than 10? at one year follow-up (5.2? on average). Conclusion The result of one stage posterior correction associated with anterior release in treatment of severe scoliosis is satisfactory. Appropriate selection of cases, detailed assessment, SEP monitoring and wake-up test during surgery are helpful to reduce severe complications. The long term results need to be followed-up.
