Posterior vertebrodesis and Ponte osteotomies in surgical treatment of adolescent idiopathic scoliosis type Lenke 1-4

Abstract

The purpose of the study is to present the results of the application of posterior vertebrodesis with Ponte osteotomies (PO) in the operative treatment of adolescent idiopathic scoliosis /AIS/, Lenke 1-4. The study encompasses patients with more than 60 degrees Cobb angle rigid deformities in the frontal plane with correction below 40% percents in the bending tests. Patients with both hyperkyphosis reported in the T5-T12 segment and marked hypokyphosis in the same area of the thoracic zone were also included in the study.
 Material and methods
 The study encompasses 38 patients (men 11, women 27) with adolescent idiopathic scoliosis type Lenke 1-4 and has been conducted in the period 2010-2018 The patients, included in the study, were of the age between 10 and 18 years, average age: 14.2±0.5.
 Results
 The following results were reported: Correction at one level osteotomy - 8-11 degrees in kyphosis and less than 5 degrees in the coronal plane; Blood loss at one level osteotomy: 50-95 ml; Time for osteotomy at one level:19-28 min.
 Conclusion
 Ponte osteotomy and posterior instrumentation with pedicle screws is an effective and relatively safe surgical method to achieve good sagittal and frontal correction in cases with pronounced and rigid thoracic deformities. The performance of osteotomies is associated with increased blood loss and operative time, but it is of key importance in achieving an important correction of the sagittal disorder in hyper or hypokyphosis cases.