A novel approach to surgical treatment of adolescent idiopathic scoliosis in skeletally immature patients

Purpose

Describe the surgical technique and experience using the LSZ growing system in skeletally immature patients for two–stage surgical treatment of adolescent idiopathic scoliosis (AIS).

Methods

Eleven skeletally immature patients who underwent two-stage surgical treatment of AIS in our center were retrospectively analyzed. Patients initially treated with the LSZ growing system were observed for an average of 40.5 months (range 23–64 months) and for 4 years after planned replacement of the LSZ growing system with a standard pedicle screw system.

Results

The average preoperative angle of the main thoracic curve was 64.55 ± 3.21°, and that of the lumbar curve was 46 ± 5.52°. After instrumentation using the LSZ growing system, the thoracic curve was corrected to 17.63 ± 5.14°, and the lumbar curve to 9.2 ± 5.45°. The correction percentages were 72.52 ± 8.35 and 80.59 ± 10.77, respectively. After planned replacement of the LSZ system with a pedicle screw system, the angle of the thoracic curve changed to 11.45 ± 4.84°, and the lumbar curve to 6.4 ± 4.72°. The percentages of final correction were 82,1 ± 7,91 and 85,64 ± 5,47, respectively. The difference in the “LSZ growth coefficient” was 0.063 ± 0.037, which indicates continued growth of the spine along the instrumented region. None of the patients had neurological or infectious complications.

Conclusion

Our study demonstrates the safety and effectiveness of 2-stage treatment of AIS using the LSZ system, which allows for spine growth during the period between stages.