Pooria Hosseini1, Allen Carl2, Michael Grevitt3, Colin Nnadi4, Martin Repko5, Dennis G Crandall6, Ufuk Aydinli7, Ľuboš Rehák8, Martin Zabka9, Steven Seme10, Behrooz A Akbarnia1. 1. San Diego Spine Foundation, San Diego, California. 2. Albany Medical Center, Albany, New York. 3. Nottingham University Queens Medical Centre, Nottingham, UK. 4. Nuffield Orthopaedic Centre, Oxford University Hospital, Headington, Oxford, UK. 5. University Hospital Brno, Orthopaedic Department Faculty, Brno, Czech Republic. 6. Sonoran Spine Center, Tempe, Arizona. 7. Medicabil Hospital, Nilufer, Bursa, Turkey. 8. Comenius University, Bratislava, Slovakia. 9. Department of Orthopaedics and Traumatology, University Hospital Bratislava, Ruzinovska, Bratislava, Slovakia. 10. Seme Device Consulting, Savage, Minnesota.
Abstract
BACKGROUND: This trial reports the 2-year and immediate postremoval clinical outcomes of a novel posterior apical short-segment (PASS) correction technique allowing for correction and stabilization of adolescent idiopathic scoliosis (AIS) with limited fusion. METHODS: Twenty-one consecutive female AIS patients were treated at 4 institutions with this novel technique. Arthrodesis was limited to the short apical curve after correction with translational and derotational forces applied to upper and lower instrumented levels. Instrumentation spanned fused and unfused segments with motion and flexibility of unfused segments maintained. The long concave rods were removed at maturity. Radiographic data collected included preoperative and postoperative data for up to 2 years as well as after long rod removal. RESULTS: All 21 patients are beyond 2 years postsurgery. Average age at surgery was 14.2 years (11-17 years). A mean of 10.5 ± 1 levels per patient were stabilized and 5.0 ± 0.5 levels (48%) were fused. Cobb angle improved from 56.1° ± 8.0° to 20.8° ± 7.8° (62.2% improvement) at 1 year and 20.9° ± 8.4°, (62.0% improvement) at 2 years postsurgery. In levels instrumented but not fused, motion was 26° ± 6° preoperatively compared to 10° ± 4° at 1 year postsurgery, demonstrating 38% maintenance of mobility in nonfused segments. There was no report of implant-related complications. CONCLUSIONS: PASS correction technique corrected the deformity profile in AIS patients with a lower implant density while sparing 52% of the instrumented levels from fusion through the 2-year follow-up.
BACKGROUND: This trial reports the 2-year and immediate postremoval clinical outcomes of a novel posterior apical short-segment (PASS) correction technique allowing for correction and stabilization of adolescent idiopathic scoliosis (AIS) with limited fusion. METHODS: Twenty-one consecutive female AIS patients were treated at 4 institutions with this novel technique. Arthrodesis was limited to the short apical curve after correction with translational and derotational forces applied to upper and lower instrumented levels. Instrumentation spanned fused and unfused segments with motion and flexibility of unfused segments maintained. The long concave rods were removed at maturity. Radiographic data collected included preoperative and postoperative data for up to 2 years as well as after long rod removal. RESULTS: All 21 patients are beyond 2 years postsurgery. Average age at surgery was 14.2 years (11-17 years). A mean of 10.5 ± 1 levels per patient were stabilized and 5.0 ± 0.5 levels (48%) were fused. Cobb angle improved from 56.1° ± 8.0° to 20.8° ± 7.8° (62.2% improvement) at 1 year and 20.9° ± 8.4°, (62.0% improvement) at 2 years postsurgery. In levels instrumented but not fused, motion was 26° ± 6° preoperatively compared to 10° ± 4° at 1 year postsurgery, demonstrating 38% maintenance of mobility in nonfused segments. There was no report of implant-related complications. CONCLUSIONS: PASS correction technique corrected the deformity profile in AIS patients with a lower implant density while sparing 52% of the instrumented levels from fusion through the 2-year follow-up.
Entities:
Keywords:
adolescent idiopathic scoliosis; motion preservation; short apical fusion
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