title: Single-staged double anterior and posterior spinal reconstruction for rigid adult spinal deformity: a report of four cases.
abstract: BACKGROUND
  Sequential anterior/posterior spinal reconstruction for rigid adult spinal deformity has become a standard operative option. Single-staged double anterior/posterior spinal reconstruction for rigid double major curvature has not been reported in the literature to date.
  
  
  OBJECTIVE
  To report a previously unreported approach for rigid double major curvature of the thoracic and thoracolumbar spine with emphasis on indications and avoiding complications.
  
  
  METHODS
  Four cases of sequential double anterior/posterior spinal reconstruction are reported.
  
  
  METHODS
  Single-staged double anterior spinal reconstruction was performed on four adult patients with rigid thoracic and thoracolumbar scoliosis. Osteotomies were performed by the anterior and posterior approach and followed by posterior instrumentation. A right thoracotomy and left retropleural/retroperitoneal approach was performed for each patient followed by the posterior approach in a single stage.
  
  
  RESULTS
  Only one complication occurred, a posterior dural tear, treated without incident. A high level of patient satisfaction and return to activity was noted. Solid arthrodesis with good coronal and sagittal balance occurred in all patients.
  
  
  CONCLUSIONS
  Single-staged double anterior/posterior spinal reconstruction for rigid adult deformity can be performed safely and effectively with good patient outcome. The procedure should be reserved only for those patients with severe double major curvature of similar magnitude and rigidity.
authors.affiliation: Department of Orthopedic Surgery, Hospital for Joint Diseases, 301 E. 17th Street, New York, NY 10003, USA. BLonner@nyc.rr.com
authors.forename: Baron S
authors.initials: BS
authors.lastname: Lonner
authors.forename: Sai Kiran
authors.initials: SK
authors.lastname: Murthy
authors.forename: Oheneba
authors.initials: O
authors.lastname: Boachie-Adjei
mesh_terms: D000328:Adult; D017586:Diskectomy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D009127:Muscle Rigidity / Q000175:diagnosis / Q000601:surgery*; D009984:Orthopedic Fixation Devices; D010147:Pain Measurement; D017060:Patient Satisfaction; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology*; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods*; D020127:Recovery of Function; D018570:Risk Assessment; D012494:Sampling Studies; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000601:surgery*; D013904:Thoracic Vertebrae; D016896:Treatment Outcome