Idiopathic Scoliosis: Correction and Fusion with Pedicle Screws, without Instrumentation at the Apex

Abstract

Introduction Vertebrae of the scoliosis apex are more difficult to instrument with pedicle screws, because they are commonly the most rotated and dystrophic. We evaluated the postoperative radiographical results of scoliosis surgery with pedicle screws, without instrumenting the apex vertebra or its adjacent vertebrae. Patients and Methods This study is a radiographical retrospective study. A total of 24 patients with diagnosis of idiopathic scoliosis, with a minimum of 2 years' follow-up, were treated with correction and fusion, using pedicle screws. The apex vertebrae or its adjacent vertebrae were not instrumented (one to four levels). The correction index, sagittal and coronal alignment, clavicle angle, and rotation of the apex were measured at the immediate postoperative period and 2 years after surgery. The correlation between correction and apical levels without instrumentation was also calculated. Results The correlation between correction and the noninstrumented levels around the apex was not significant ( r = − 0.18; p = 0.41). Radiographical parameters of correction were acceptable at the immediate postoperative and 2 years after surgery. Conclusion There was no correlation between correction and noninstrumented levels around the apex. Not instrumenting the apex could be an option that shows some potential benefits. The correction indexes and both sagittal and coronal balance were acceptable. There was no correction loss at 2 years after surgery.