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Review
. 2020 Jan;8(2):31.
doi: 10.21037/atm.2019.11.84.

Anterior instrumented fusion for adolescent idiopathic scoliosis

Michael Ruf  1 , Jörg Drumm  1 , Dezsö Jeszenszky  2
Affiliations
Review

Anterior instrumented fusion for adolescent idiopathic scoliosis

Michael Ruf et al. Ann Transl Med. 2020 Jan.

Abstract

Adolescent idiopathic scoliosis (AIS) is a complex three-dimensional deformity of the spine consisting of a lateral curvature, apical vertebral rotation, and an impairment of the sagittal profile. Surgical options include anterior and posterior approaches. Anterior instrumented fusion is suitable in Lenke type 1 and 5 curves. It supplies excellent results in coronal plane correction and is superior in the restoration of the sagittal profile and apical derotation. Fusion is shorter compared to posterior correction, and the complication rate is low. Pulmonary function is impaired postoperatively but recovers within a few years.

Keywords: Adolescent idiopathic scoliosis (AIS); anterior approach; correction; derotation; pulmonary function; thoracic kyphosis.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Surgical approach to the thoracic spine via a double thoracotomy.
Figure 2
Figure 2
A 14 years old girl with adolescent idiopathic thoracic scoliosis. (A,B,C,D) Thoracic hypokyphosis causes cervical kyphosis; (E,F) the long-term follow-up radiographs 18 years after surgery shows the instrumentation T5–12 with solid fusion. The straight lumbar spine, no degenerative changes: sagittal profile is restored with physiological cervical lordosis.
Figure 3
Figure 3
A 16 years old girl with a thoracolumbar scoliosis (Lenke 5C) (A,B,C,D,E,F), one year postoperatively following anterior correction and fusion (G) and five years postoperatively: well-balanced spine with a short instrumentation and fusion (H,I).
Figure 4
Figure 4
The 3D imaging reveals the severe hypokyphosis/lordosis in the scoliotic thoracic spine. Anterior shortening restores a physiologic sagittal profile.
Figure 5
Figure 5
Rigid scoliosis Lenke 2A in a 12-year-old girl (A,B) and one week after anterior release with shortening of the anterior column of the spine without instrumentation (posterior instrumentation planned): spontaneous correction of scoliosis, restoration of thoracic kyphosis (standing position) (C,D).
See this image and copyright information in PMC

References

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