Treatment of severe scoliosis with posterior-only approach arthrodesis and all-pedicle screw instrumentation.
OBJECTIVE
Posterior-only approach arthrodesis by all-pedicle screw instrumentation has a correction rate similar to correction obtained by traditional combined anterior/posterior approach surgery and avoids the complications associated with the thoracic approach.


METHODS
We treated 25 patients, with a mean age 16.5 years, with severe adolescent idiopathic scoliosis by posterior-only approach using all-screw instrumentation arthrodesis. Mean scoliosis curve in Cobb degrees was 95° Cobb. All cases were treated by the same senior surgeon, by free hand technique, without intraoperative neurophysiologic monitoring and spine navigation aids.


RESULTS
Mean scoliosis curve after surgery was 37° Cobb. Mean follow-up was 4 years. No perioperative complications, curve progression or arthrodesis malunion were reported at the follow-up.


CONCLUSIONS
Posterior spinal fusion with pedicle screw-only instrumentation obtains a good and stable correction of severe scoliosis; compared to hybrid instrumentation, it allows a greater coronal correction of the deformity and less correction loss at the follow-up.
Spine Disease Unit, Bambino Gesù Pediatric Hospital Roma-Palidoro, Via della Torre di Palidoro 1, Palidoro, Rome, Italy, marco.crostelli@opbg.net.
Marco
M
Crostelli
Osvaldo
O
Mazza
Massimo
M
Mariani
Dario
D
Mascello
D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D065289:Pedicle Screws; D012600:Scoliosis / Q000453:epidemiology / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods*; D013131:Spine / Q000601:surgery*