Anterior release posterior internal distraction and subsequent posterior spinal fusion for the treatment of severe kyphoscoliosis.

PURPOSE: To evaluate the outcome and complications of anterior release, posterior internal distraction and subsequent posterior spinal fusion for the treatment of severe kyphoscoliosis.
METHODS: The medical records and spinal imaging of 17 consecutive severe kyphoscoliosis patients who underwent anterior release, posterior internal distraction and subsequent posterior spinal fusion were reviewed.
RESULTS: Patients underwent spinal deformity correction at the mean age of 22.6 ± 8.4 years (range 15-44 years) with mean follow-up of 37.4 ± 12.0 months (range 24-60 months). The preoperative thoracic kyphosis of 83.5° ± 16.3° (range 60°-115°) was corrected to 37.5° ± 7.9° (range 20°-49°) at the final follow-up. The preoperative major curve of 110.1° ± 16.8° (range 92°-145°) was corrected to 33.5° ± 13.9° (range 12°-63°) at the final follow-up, with a scoliosis correction of 70.3 %. At the most recent follow-up, the correction rate of proximal thoracic curve and thoracolumbar or lumbar curve was 57.1 and 74.8 %, respectively. Transient dyspnoea occurred in one patient after the initial surgery and subsequently resolved. No ventilator support was needed. Three patients complained the pain of concave soft tissue after the first distraction. There were no neurological complications or any deep wound infections. No complication of instrumentation was found at final follow-up.
CONCLUSIONS: In the treatment of severe kyphoscoliosis, anterior release, posterior internal distraction and subsequent posterior spinal fusion, which obviates three-column osteotomy, is a good alternative correction method.