Can anterior dynamic correction be considered a new standard of surgical treatment for idiopathic scoliosis in patients with completed and terminating growth? Retrospective single-center analysis of long-term results

Abstract

BACKGROUND: Currently, the gold standard of surgical treatment of idiopathic scoliosis is dorsal or anterior correction using rigid instrumentation. However, anterior dynamic scoliosis correction has recently become a popular method for treating idiopathic scoliosis. It is recommended for patients with a certain growth potential. We present the long-term treatment results of patients with idiopathic scoliosis and the use of a dynamic correction system during completed and ending growth. AIM: To evaluate radiological and clinical data on the results of surgical treatment of idiopathic scoliosis in patients with completed and terminating growth and a FU period of 2 years. MATERIALS AND METHODS: A retrospective study of demographic data, X-ray (Cobb angle before and after surgery and ≥2 years, Lenke type, Risser test), number of fixation levels, nucleotomy, blood loss, surgery time, and complications, was conducted. The functional result was evaluated using the SRS-22. RESULTS: Eighty-seven patients (men, 4; women, 83) were included. ASC (thoracic) was performed in 30 patients; lumbar/ thoracolumbar, 32; 2 sides, 13; and hybrid system, 12. Lenke: Lenke 1 (right-sided, 18; left-sided, 7); Lenke 2, 5; Lenke 3, 19; Lenke 4, 2; Lenke 5 (left-sided, 26; right-sided, 8); and Lenke 6, 2. The average blood loss was 281.2±173 ml; operation time, 174.8±42.3 min; FU, 2.2 years; age, 23.3 years; Risser, 4.42 (3–5); number of fixed levels 7.25±1.6°; and Cobb angle in the thoracic group during the first post-op study, 27.9±5.3°, and the last at 25.2±6.9° compared with the pre-op at 62.4°±10.9° (p 0.05). No significant loss of correction was found in patients with Lenke 5,6 52.5°±8.4° before surgery, 24.2±12.4° after, and a long-term FU of 27.2°±11.6° (p 0.05). CONCLUSION: Dynamic scoliosis correction in adults is a new direction in spine surgery and provides a satisfactory radiological and functional result that persists for 2 years.