Abstract
BackgroundTo compare the clinical and radiological outcomes of the surgical correction of Lenke type 1 to 4 scoliosis by using a multilevel Ponte osteotomy procedure with posterior selective segmental pedicle screw constructs or posterior release and selective segmental pedicle screw constructs only in patients with adolescent thoracic idiopathic scoliosis.MethodsRetrospective analysis of 65 patients, 32 treated with the multilevel Ponte procedure (Group A) and 33 with posterior soft tissue release only (Group B). The groups were compared with regard to the change in spinal alignment from preoperative to postoperative assessment and over the follow-up period.ResultsA correction rate of the main thoracic curve of 63.9 ± 4.5% was obtained for group A and 65.2 ± 2.4% for group B (P = 0.17). However, the Cincinnati correction index was greater for group A (1.8 ± 0.3) than that for group B (1.4 ± 0.2, P < 0.001), with a smaller change in angle over the period from 1 week postoperatively to the 2-year follow-up (P < 0.05). The operative time, volume of blood loss, and volume of transfusion were greater for group A than for group B (P < 0.05).ConclusionThe multilevel Ponte osteotomy procedure, with posterior selective segmental pedicle screw constructs, improves the Cincinnati correction index and restores the thoracic kyphosis in patients with adolescent thoracic idiopathic scoliosis.
Highlights
To compare the clinical and radiological outcomes of the surgical correction of Lenke type 1 to 4 scoliosis by using a multilevel Ponte osteotomy procedure with posterior selective segmental pedicle screw constructs or posterior release and selective segmental pedicle screw constructs only in patients with adolescent thoracic idiopathic scoliosis
To address existing controversy regarding the role of Ponte osteotomy in the correction of adolescent idiopathic scoliosis (AIS), we undertook a retrospective analysis to compare the clinical and radiographic outcomes of surgical correction of Lenke type 1–4 curves using multilevel Ponte osteotomies combined with posterior selective segmental pedicle screw constructs or posterior release and selective segmental pedicle screw constructs only
Patient selection The patients were retrospectively identified from our surgical database using the following inclusion criteria: Lenke type 1 to 4 scoliosis, based on preoperative imaging; corrective surgery using either the multilevel Ponte osteotomy procedure combined with posterior selective segmental pedicle screw constructs or posterior selective segmental pedicle screw constructs only; and availability of complete clinical data throughout the follow-up period
Summary
To compare the clinical and radiological outcomes of the surgical correction of Lenke type 1 to 4 scoliosis by using a multilevel Ponte osteotomy procedure with posterior selective segmental pedicle screw constructs or posterior release and selective segmental pedicle screw constructs only in patients with adolescent thoracic idiopathic scoliosis. The main goal of the surgical treatment of AIS is to correct the spinal deformity, restore the coronal and sagittal balance of the spine, prevent malformations and progression, and improve appearance and. To address existing controversy regarding the role of Ponte osteotomy in the correction of AIS, we undertook a retrospective analysis to compare the clinical and radiographic outcomes of surgical correction of Lenke type 1–4 curves using multilevel Ponte osteotomies combined with posterior selective segmental pedicle screw constructs or posterior release and selective segmental pedicle screw constructs only
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