Journal of spine surgery (Hong Kong) · 2026
Correction of deformity from convexity in adolescent idiopathic scoliosis.
СтатьяНазвание и аннотация: Перевод в очереди
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Hernández Mateo José María, Flores Gallardo Jaime, Riquelme García Oscar, García Martín Azucena, Igualada Blázquez Cristina, Quevedo Narciso Tania, Solans López María Del Coro, Muñoz Núñez Laura, Esparragoza Cabrera Luis Alejandro
Аннотация
BACKGROUND: Correction of scoliosis deformity from the convexity of the curve reduces the theoretical risk of neurovascular injury, a fact to be considered, especially in the paediatric population. Our aim is to evaluate the efficacy of this technique in patients with adolescent idiopathic scoliosis (AIS).
METHODS: This is a retrospective study, in which 50 patients with AIS were included. The minimum required follow-up was 24 months. After open posterior approach and flexibilisation of the deformity by facetectomies, pedicle screws were inserted 'free-hand' in the convexity and at the extremes of the assembly at the concavity level, with intraoperative neurophysiological monitoring. In situ moulding maneuvers, segmental correction of the curve by compression-distraction and direct vertebral derrotation from the convexity were performed, using another chromium-cobalt rod on the concave side. General demographic and deformity data were collected, as well as radiological variables.
RESULTS: Fifty patients with AIS underwent surgery. The mean operative time was 251±50 min. Mean blood loss was 4.3±0.3 g/dL Hb. The mean postoperative stay was 6.3±0.3 days. A reduction of the Cobb angle was achieved in primary curve by 64.4% (from 53.0°±12.6° to 18.9°±9.5°; P<0.001) and in secondary curve by 47% (from 33.3°±11.4° to 17.5°±9.5°; P=0.005). Coronal balance changed from 3.6±1.9 to 2.3±4.2 mm (P=0.59) and sagittal vertical axis (SVA) changed from -14.7±40 to -6.1±28.9 mm (P=0.10). There were no vascular complications. A single intraoperative neurophysiological event was recorded, requiring screw repositioning. Two wound infections were recorded.
CONCLUSIONS: Correction of the deformity from the convexity using low-density constructs with pedicle screws, achieves similar results to other techniques.
METHODS: This is a retrospective study, in which 50 patients with AIS were included. The minimum required follow-up was 24 months. After open posterior approach and flexibilisation of the deformity by facetectomies, pedicle screws were inserted 'free-hand' in the convexity and at the extremes of the assembly at the concavity level, with intraoperative neurophysiological monitoring. In situ moulding maneuvers, segmental correction of the curve by compression-distraction and direct vertebral derrotation from the convexity were performed, using another chromium-cobalt rod on the concave side. General demographic and deformity data were collected, as well as radiological variables.
RESULTS: Fifty patients with AIS underwent surgery. The mean operative time was 251±50 min. Mean blood loss was 4.3±0.3 g/dL Hb. The mean postoperative stay was 6.3±0.3 days. A reduction of the Cobb angle was achieved in primary curve by 64.4% (from 53.0°±12.6° to 18.9°±9.5°; P<0.001) and in secondary curve by 47% (from 33.3°±11.4° to 17.5°±9.5°; P=0.005). Coronal balance changed from 3.6±1.9 to 2.3±4.2 mm (P=0.59) and sagittal vertical axis (SVA) changed from -14.7±40 to -6.1±28.9 mm (P=0.10). There were no vascular complications. A single intraoperative neurophysiological event was recorded, requiring screw repositioning. Two wound infections were recorded.
CONCLUSIONS: Correction of the deformity from the convexity using low-density constructs with pedicle screws, achieves similar results to other techniques.