Selection of methodology in surgical treatment of adolescent idiopathic scoliosis.
Before contemplating any surgical procedure, one has to define the goals of the operative procedure. The patient should be evaluated thoroughly by physical examination and by adequate radiographs, including bending films. The surgeon should be familiar with different types of techniques and their qualities. The goals of surgery should be outlined clearly and understood between the physician and the patient. The patient should be provided with sufficient and easy-to-understand information (Table 1), and be encouraged to have an input in the decision-making process. For instance, is the goal of surgery to stop progression? To achieve cosmetic correction? To preserve maximal spinal mobility or to help improve pulmonary function? Is it important for the patient to be cast free postoperatively? Once the goal is defined, and we are aware of the abilities of each technique, then we can arrive at a realistic expectation. Again, it is of utmost importance that the surgeon select the procedure that he or she has adequate experience in performing.
Akbarnia
B A
BA
Department of Orthopedic Surgery, St. Louis University, School of Medicine, Missouri.
D000293:Adolescent; D006801:Humans; D009984:Orthopedic Fixation Devices; D011859:Radiography; D012600:Scoliosis / Q000000981:diagnostic imaging*; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods*