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Selective fusion for adolescent idiopathic scoliosis linked with spontaneous correction of uninstrumented curves
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In properly selected patients with adolescent idiopathic scoliosis, selective fusion of either a main thoracic or lumbar curve resulted in spontaneous correction of the uninstrumented curve, according to recently published results. The results were maintained at least 10 years.
Researchers identified 51 patients who underwent selective fusions for adolescent idiopathic scoliosis, of which 21 were main thoracic curve fusions and 30 were thoracolumbar/lumbar curve fusions. Patients were followed for at least 10 years. The coronal and sagittal Cobb angles and coronal balance were evaluated with interval radiographs. Investigators cataloged and evaluated the Scoliosis Research Society Questionnaire (SRS-24) scores. Repeated measure analysis of variance was used to compared radiograph outcomes and SRS-24 scores between preoperative and postoperative time points. Patient records were screened for recent curve progression more than 5° and then methodically assessed.
Results showed that at 10 years, the instrumented main thoracic curve corrected by an average of 51% and the thoracolumbar/lumbar curve corrected by 60%. At 5 years postoperatively, the uninstrumented compensatory curves corrected gradually and approached the magnitude of a fused curve. At 10 years postoperatively, the correction was maintained and led to “excellent” coronal balance, according to the researchers.
A subgroup of patients saw compensatory progression of the uninstrumented curve due to recent progression of the primary curve adjacent to prior fusion or within instrumented segments. Overall, during follow-up, the SRS scores did not decrease. In addition, no patients needed secondary operations. – by Monica Jaramillo
Disclosures: Louer reports no relevant financial disclosures. Please see the full study for a list of all other author’s relevant financial disclosures.
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