Abstract
Objective: To compare the surgical outcome of patients with right thoracic adolescent idiopathic scoliosis undergoing: 1). Single-stage anterior spinal release and posterior instrumented fusion with costoplasty, 2). Staged anterior spinal release and posterior instrumented fusion with costoplasty.
Study Design-Material: A retrospective study was performed including 20 consecutive patients for each surgical group.
Summary of Background Data: Scoliosis surgery in our institution has evolved over the past decade with respect to the interval between the anterior and posterior procedure. It was typical in the 1980’s/early 1990’s for the patients who required combined anterior-posterior spinal fusion to have 2 weeks between stages. This interval has now been reduced to one week by all our scoliosis surgeons. The authors recently endeavor to perform single-stage anterior-posterior procedures with costoplasty for all right thoracic curves in patients with adolescent idiopathic scoliosis.
Methods: The medical records and radiographs of the 40 patients were reviewed.
Results: The patients in both groups have been assessed for: 1). Correction of spinal deformity achieved with the operation, 2). Incidence of perioperative complications, 3). In-patient stay, 4). Postoperative course. The results were comparative between the 2 groups. Considerable curve correction was obtained with the combined anteroposterior spinal surgery and maintained at follow-up in both groups. No difference in the incidence of complications was recorded between the same-day and the staged groups. Less hospitalization time and time spent in the intensive care unit were required for the patients who underwent same-stage sequentially performed anterior-posterior spinal procedures.
Conclusions: This study showed that single-stage anterior-posterior surgery for right thoracic adolescent idiopathic scoliotic curvatures is a safe and efficacious procedure with no documented adverse effects for the patients. We believe that when a combined anteroposterior spinal approach is necessitated, the one-stage surgery could be considered the procedure of choice for the management of this type of scoliotic deformity.
The abstracts were prepared by Mr Peter Millner. Correspondence should be addressed to Peter Millner, Consultant Spinal Surgeon, Orthopaedic Surgery, Chancellor Wing, Ward 28 Office Suite, St James’ University Hospital, Beckett Street, Leeds LS9 7TF.
