Abstract
Introduction and Aims: The aim of this paper is to review an innovative anterior technique to address double major scoliotic deformities in paediatric patients. This technique, which utilises modified lumbar anterior rod placement followed by an overlapped thoracic rod placed in the concavity of the thoracic curve, may have a considerable role in managing double major scoliotic deformities.
Method: All patients undergoing double anterior rod instrumentation for idiopathic scoliosis at the author’s institution were reviewed. They were closely assessed and reviewed for any negative effects. Radiographs were evaluated for correction of the scoliotic deformity and correction of the obliquity of the end vertebra. Disc space fusion was also evaluated on follow-up films.
Results: Patients requiring thoracic and lumbar instrumentation were considered for the technique. Mean pre-operative curve sizes were 53 and 59 degrees for the thoracic and lumbar curves, respectively. The described operative technique utilises a modified lumbar anterior rod placement followed by an overlapped thoracic rod placed in the concavity of the thoracic curve. Thoracic vessels are preserved in this technique. Mean operative time was 7.5 hours.
Anterior instrumentation has been completed in five patients at the author’s institution. Obliquity of L3 was corrected from a mean of 29 degrees pre-operatively to five degrees post-operatively. No patients had significant decompensation nor did they require any further procedure. No post-operative complications occurred. The technique allows for one incision instrumentation of double major curves to the lower end vertebra, preserving the L3-4 motion segment.
Conclusion: Anterior instrumentation is useful in patients with double major scoliotic deformities who require thoracic and lumbar instrumentation. This new technique may have a significant role in the management of a subset of idiopathic scoliosis patients as it preserves the L3-L4 motion segment, while allowing one-incision instrumentation of double major curves.
These abstracts were prepared by Editorial Secretary, George Sikorski. Correspondence should be addressed to Australian Orthopaedic Association, Ground Floor, The William Bland Centre, 229 Macquarie Street, Sydney, NSW 2000, Australia.
One or more of the authors are receiving or have received material benefits or support from a commercial source.
