Effectiveness of Facetectomy in Correction of Adolescent Idiopathic Scoliosis

Abstract

Introduction: Surgical correction of adolescent idiopathic scoliosis (AIS) using the facetectomy technique with the utilization of segmental pedicle screws aims to achieve correction of coronal and sagittal imbalances and preserve normal neurological function. In this study, we aimed to certify the effectiveness of the facetectomy technique in the correction of AIS by analyzing technique outcomes.

Methods: This is a retrospective, single-center study. From January 2018 to March 2022, a total of 51 patients with AIS who underwent inferior facetectomy with segmental pedicle screw constructs at the Royal Rehabilitation Center were reviewed. Radiological parameters including the major curve Cobb angle, and global coronal balance were evaluated preoperatively, postoperatively, and at the final follow-up. Surgical parameters and complications were also reported.

Results: The mean major curve Cobb angle was 59.5 ± 4.9° preoperatively, 13.6 ± 2.7° postoperatively, and 14.5 ± 2.6° at the final follow-up, with correction rates of 77.2% and 75.7%, respectively. The mean global coronal balance was 2.7 ± 1.1 cm preoperatively, 1.7 ± 0.73 cm postoperatively, and 1.4 ± 0.55 cm at the final follow-up. Two cases of pleural injuries were reported intraoperatively. Postoperatively, two cases experienced superficial wound infections, one experienced pulmonary embolism, and one patient had revision surgery due to the loosening of a single screw. None of these complications lasted long.

Conclusions: When combined with posterior segmental pedicle screw constructs, inferior facetectomy can provide an effective rate of correction in a reasonably safe manner.

Keywords: adolescent idiopathic scoliosis; curve cobb angle; facetectomy; global coronal balance; pedicle screws; posterior fusion.

Figure 1. A 16-year-old male patient who underwent inferior facetectomies with pedicle screws instrumentation from T3-L4 levels. (A) preoperative posterior anterior (PA) x-rays, (B) immediate postoperative PA x-rays, (C) immediate postoperative lateral view x-rays, (D) follow-up after 12 months PA x-rays, and (E) follow-up after 12 months lateral view x-rays.