Vertebral body stapling as an alternative in the treatment of idiopathic scoliosis

Abstract

Objective: Unilateral vertebral body stapling as a fusionless alternative to control curvature progression in patients with idiopathic scoliosis (IS).

Indications: Skeletally immature patients (Risser 0 or 1) with IS measuring 20-45° and correction of the curvature <20° on side-bending X-rays.

Contraindications: Congenital scoliosis, curvature above T4 or below L4, thoracic kyphosis >40°.

Surgical technique: Unilateral disc-sparing staples are placed at the convex side. A thoracoscopic approach can be used for thoracic curves and a mini-open retroperitoneal approach for lumbar curves.

Postoperative management: Early ambulation on postoperative day 1 is encouraged. There are no absolute activity restrictions, and no bracing beyond 4 weeks is required.

Results: A total of 28 patients (4 males, 24 females; average age at operation 9.4 years) met all inclusion criteria and had a minimum 2-year follow-up (range 2-5.3 years). The success rate (improvement or stabilization of the curvature) was 86% for thoracic curves <35° and all lumbar curves meeting the indications.