Ahead of Print: Instrumentation Only in Congenital Scoliosis

Screen Shot 2013-10-09 at 2.29.38 PMBackground: Although effective correction of deformity in congenital scoliosis can often be achieved with instrumentation only and without more invasive techniques such as hemivertebrectomy, reports on the feasibility of correction with instrumentation only are lacking.

Objective: To compare the results of deformity correction using instrumentation only versus hemivertebrectomy, and to examine the feasibility of and indications for correction with instrumentation only in patients with congenital scoliosis.

Methods: Twenty-five patients underwent correction with either instrumentation only (n = 14) or hemivertebrectomy (n = 11). The two patient groups were compared in terms of age at the time of surgery, preoperative magnitude and flexibility of the main curve, correction rates after surgery and at the final follow-up, surgery time, estimated blood loss, and complications.

Results: The two groups did not differ significantly in terms of average patient age or curve magnitude, but the correction with the instrumentation-only group had greater preoperative curve flexibility (37.1%) than the hemivertebrectomy group (21.0%). The correction rates immediately after surgery were high in both groups. The correction with instrumentation only group had a shorter mean operation time (308 versus 366 minutes) and less blood loss (540 versus 1547 mL) than the hemivertebrectomy group.

Conclusion: Satisfactory correction of congenital scoliosis can be obtained with instrumentation only if there is adequate flexibility in the main curve, thus avoiding the need for more invasive procedures such as hemivertebrectomy.

From: Feasibility of Correction with Instrumentation Only in Congenital Scoliosis by Lee et al.

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