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SURGICAL CORRECTION OF ADOLESCENT IDIOPATHIC SCOLIOSIS BY MEANS OF CD INSTRUMENTATION

  • M. S. Filipovic
  • Z. B. Milinkovic
  • V. Basara

J Turk Spinal Surg 1990;1(1):19-21

Our experience includes 30 operations on 30 patients with idiopathic scoliosis, 22 of which were females and 8 males. Minimum follow-up period was one year and average age of the patients 13 years (11-16). We have had 13 patients with thoracic curvature (instrumentation T5-L1), 6 patients with double (thoracic+lumbar) curvature (instrumentation T5-L4), 5 patients with thoracolumbar curve (instrumentation T10-L4) and 5 patients having curvature in the lumbar region (instrumentiation T10-L4).

Preoperative angulation ranged from 55° to 95° (mean initial angulation being 65°). Postoperative angulation was 16° (12°-30°), or 74% correction of the average initial angulation. Preoperative rotation measured by Perdriolle ruler was 40° (25-45°) and postoperative rotation 30° (15-35°). Achievement of normal thoracal kyphosis in cases of thoracal lordosis (13 cases) was satisfactory although not spectacular. Lumbar lordosis was preserved in all cases. Average loss of the correction at follow-up examinations (one year after operation) was 5° (2-7°). Solid bone calus oceured 9-10 months after the operation and can be seen on lateral X-rays of the spine. In all cases we performed spinal cord monitoring by using intra-operative awakening and test of foot movement. No abnormalities were found during the wake-up test. Complications oceured in 3 cases and they mainly refered to hook dislocations. From the aesthetic aspect, all the obtained resilts were satisfactory. In case where initial angulation was 95° thoracophrenolumbotomy with anterior fusion was done in the first stage and posterior fusion with CD instrumentation in the second stage. All patients were ambulatory in the second week after operation, without any external support and returned to their school or family activities.

Keywords: CD instrumentation, posterior fusion, scoliosis.