Aim. To investigate anterior instrumented corrective fusion for thoracolumbar or lumbar scoliosis. Methods. A retrospective review of medical records and radiographs of 38 consecutively managed patients who underwent anterior spine surgery for thoracolumbar curves by a single surgeon between 2001 and 2011. The cohort consisted of 28 female and 10 male patients with idiopathic scoliosis as the commonest aetiology. Data collated and analysed included patient demographics, surgical factors, post-operative management and complications. In addition, radiographic analysis was performed on pre-operative and follow-up x-rays. Results. Thoracolumbar/lumbar curves were corrected from 70 to 27 degrees. The thoracic compensatory curve spontaneously corrected from 34 to 19 degrees. Sagittal imbalance of greater than 4 centimeters was found in 40 percent of patients preoperatively and in 16 percent post operatively (85 percent negative sagittal imbalance, 15 percent positive sagittal imbalance). Rotation according to the Nash-Moe method corrected by 1.13 of a grade. Average operative time was 194 minutes and estimated blood loss was 450 ml. The diaphragm was taken down in 36 of the 38 patients but no post-op ventilation was required. The average high care stay was 1.2 days. Average follow-up was 18 months. Good maintenance of correction was shown at most recent follow-up, with the mean thoracolumbar/lumbar curve measuring 29 degrees, and the mean compensatory thoracic curve measuring 21 degrees. There were no significant neurological or respiratory complications. Conclusion. Anterior corrective fusion for thoracolumbar and lumbar scoliosis is effective in both deformity correction and maintenance thereof. Spontaneous correction of the thoracic curve can be expected and thus limit the fusion to the lumbar curve. Despite the concerns of taking down the diaphragm, there is minimal morbidity. NO DISCLOSURES

Adolescent idiopathic scoliosis (AIS) is a complex three-dimensional deformity of the spine characterized by a Cobb angle of at least 10 degrees. The goal of surgery is to not only prevent progression but restore sagittal and coronal balance, protecting cardiopulmonary function and improving cosmesis. We reviewed the impact of deformity correction surgery in terms of radiology and patient reported outcome(PROMs). The senior authors prospectively maintained database from 2003 –2022 was retrospectively analysed in terms of pre- and post-operative patient reported outcome measures (SRS 22) as well as radiological parameters. 44 patients with AIS were identified with pre and post op PROMS. The average age at surgery was 15yrs with 84% female. 38% had a Lenke 1 curve and 3 patients had Lenke 6 curves. 73% had posterior surgery. There was a total improvement in SRS 22 scores by 7.8%. Patients reported significant satisfaction with treatment 4.8/5 and improvement in self-image with a change of 0.4 (p<0.001). However, no difference in function, pain and mental health were recorded. Overall, proximal thoracic (PT) curves improved from 24 degrees to 11 degrees (p<0.001), Main thoracic (MT) curve 55 degrees to 19 degrees and Thoracolumbar/Lumbar curves (TL/L) 45 degreesto 11 degrees. Pre-operative flexibility and post-operative correction were 0.40 and 0.41 respectively for PT curve. MT was 0.32 and 0.67. That for TL/L was 0.57 and 0.71 respectively. Surgery yields significant main curve correction correlating with high patient reported satisfaction rate. Although total SRS 22 score yielded 7.8% improvement, sub-analysis of self-image showed the most significant improvement