THORACIC ADOLESCENT IDIOPATHIC SCOLIOSIS: CORRECTION WITH TRANSLATION USING POLYAXIAL REDUCTION SCREWS
Journal Title: Journal of Turkish Spinal Surgery - Year 2004, Vol 15, Issue 1
Abstract
Introduction: Since the introduction of Cotrel Dubousset instrumentation for three dimensional correction of scoliosis using rod rotation maneuver, newer techniques have been developed providing reduction through translation. In these techniques, translation is mainly achieved by using sublaminar wiring and pedicle hooks. Widespread use of thoracic transpedicular screws, the possibility to use polyaxial reduction screws for translation has appeared. Material Method: 65 adolescent idiopathic scoliosis (AlS) patients with thoracic deformities have been treated with posterior instrumentation and fusion between 1996-2001. Transpedicular screws were used in all of these instrumentations (Synergy Spinal System, Moss Miami). Reduction screws placed on the concave side of the deformity were tightened and the vertebral column was gradually approximated to the rod, providing correction. Thoracoplasty was performed in 52 of the patients within the same session. Results: Mean follow-up was 28 months (range 14-70 months). Mean preoperative Cobb angle was 56° (range 40°-92°), while postoperatively it decreased to 12° (range 0°-28°). Mean ratio of correction was found to be 78% (range % 56-100). No neurological complication was encountered. Frontal imbalance was noted in four patients in the early postoperative period, which were controlled with braces. Conclusion: Significant correction may be achieved in thoracic AlS through posterior instrumentation with polyaxial reduction screws. Additional thoracoplasty provides a better cosmetic outcome.
Authors and Affiliations
Cüneyt ÞAR, Önder KILIÇOÚLU
Keywords
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