2007, Number 2
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ABSTRACTBackground: We undertook this study to determine the surgical treatments results performed often to correct scoliosis in the Spinal Surgery Service in the INR/Orthopedics (National Institute of Rehabilitation/Orthopedics), Mexico City.
Methods: We conducted a longitudinal, prospective, descriptive, and clinical study with a deliberated intervention controlled from a historical cohort. One hundred twenty patients with scoliosis were reviewed in whom surgery was performed during 1990-1999. For quantitative variables, pre- vs. posoperative measures were compared using non-parametric means with χ2 or in this case with ANOVA by Kruskal-Wallis test. Differences are considered significant if p ‹0.05.
Results: Age average of patients was 12 years. There were 75 females and 45 males. There were 59 idiopathic scoliosis cases and 54 congenital scoliosis cases. Anterior approach was accomplished in 61 cases with posterior fixation. Posterior approach was used in 54 cases. There were 76 cases of Luque segmental instrumentation. Pre-operatively, scoliosis was ranked (18 to 110 grades) and posoperatively (5 to 90 grades) (p = 0.00001). There were 21 complications, 9 due to injuries or infection. In 76 patients, different fixation techniques were used, obtaining a correction average of 14.47 grades. Forty four patients were structured with bars, four distal screws, two compression screws, proximal hooks with sublaminar wire, and the angle was reduced on average 23.11 grades.
Conclusions: Average reduction of scoliosis was higher with the modified Luque III instrumentation (p ‹0.045). There was no difference between etiology and preoperative angle.
Weinstein SL. Idiopathic scoliosis natural history. Spine 1986;11:780.
2. Hermosilla M, Beaulieu L, Pantoja S. Escoliosis patología ortopédica. Chile: LYE;2004.
3. Wonk HK, Hui JH. Idiopathic scoliosis in Singapore schoolchildren: a prevalence study 15 years into screening program. Spine 2005;30:1188-1196.
4. Shands AR, Eisberg HB. The incidence of scoliosis in the state of Delaware: a study of 50,000 minifilms of the chest made during a survey for tuberculosis. J Bone Joint Surg 1955;37A:1243.
5. Bahensky H, Giesinger K, Ogon M. Multisurgeon assessment of coronal pattern classification systems for adolescent idiopathic scoliosis. Spine 2002;27:762-767.
6. Miller NH. Genetics of familial idiopathic scoliosis. Clin Orthop Relat Res 2002;401:60-64.
7. Wise CA, Barnes R, Gillum J, Herring JA, Bowcock AM, Lovett M. Localization of susceptibility of familial idiopathic scoliosis. Spine 2000;25:2372-2380.
8. Goldberg CJ, Moore DP, Fogarty EE, Dowling FE. Left thoracic curve patterns and their association with disease. Spine 1999;24:1228-1233.
9. Moe JH, Winter RB. Deformaciones de la columna vertebral. Segunda edición. Barcelona, España: Salvat Editores;1984.
10. Crenshaw, Campbell. Cirugía ortopédica. Octava edición. Argentina: Panamericana; 1994.
11. Liljenqvist U. The natural history of congenital defects and deformities of the spine. Versicherungsmedizin 2005;57:3-7.
12. Hedequist DJ, Hall JE, Emans JB. The safety and efficacy of spinal instrumentation in children with congenital spine deformities. Spine 2004;29:2081-2116.
13. Hefti F. Congenital anomalies of the spine. Orthopade 2002;31:34-43.
14. Rothman-Simeone. Columna vertebral. 4th ed. Mexico: McGraw-Hill Interamericana; 2000.
15. McCance SE, Denis F. Coronal and sagittal balance in surgically treated adolescent idiopathic scoliosis with the King curve pattern. Spine 1998;23:2063-2073.
16. Vedantam R, Crawford A. The role of preoperative pulmonary function tests in patients with adolescent idiopathic scoliosis undergoing posterior spinal fusion. Spine. 1997;22:2731-2734.
17. Richards BS, Herring JA. Treatment of adolescent idiopathic scoliosis using Texas Scottish Rite hospital instrumentation. Spine 1994;19:1598-1605.
18. White SF, Asher MA, Lai SM. Patients’ perceptions of overall function, pain, and appearance after primary posterior instrumentation and fusion for idiopathic scoliosis. Spine 1999;24:1693.
19. Lu W, Hu Y, Luk K. Paraspinal muscle activities of patients with scoliosis after spine fusion. Spine 2002;27:1180-1185.
20. Wattenbarger M, Richards S, Herring J. A comparison of single-rod instrumentation with double-rod instrumentation in adolescent idiopathic scoliosis. Spine 2000;25:1680-1688.
21. Sweet FA, Lenke L, Birdwell K. Prospective radiographic and clinical outcomes and complications of single solid rod instrumented anterior spinal fusion in adolescent idiopathic scoliosis. Spine 2001;26:1956-1965.
22. Conrad R, Murrell G, Motley G. A logical coronal pattern classification of 2000 consecutive idiopathic scoliosis cases based on the scoliosis research society-defined apical vertebra. Spine 1998;23:1380-1391.
23. Schwab F, Smith V, Biserne M. Adult scoliosis: a quantitative radiographic and clinical analysis. Spine 2002;27:387-392.
24. Suk SI, Kim WJ, Lee C. Indications of proximal thoracic curve fusion in thoracic adolescent idiopathic scoliosis. Spine 2000;25:2342-2349.
25. Padua R, Padua S, Aulisa L. Patient outcomes after Harrington instrumentation for idiopathic scoliosis. Spine 2001;26:1268-1273.
26. IIkaa H, Ville R, Timo Y. Does gender affect outcome of surgery in adolescent idiopathic scoliosis? Spine 2005;30:462-467.
27. Kotaro S, Lenke L, Yongjung K. Analysis of the lowest instrumented vertebra following anterior spinal fusion of thoracolumbar and lumbar adolescent idiopathic scoliosis: can we predict posoperative disc wedging? Spine 2005;30:418-426.
28. Remes V, Helenius I, Schlenzka D. Cotrel-Dubousset (CD) or universal spine system (USS) instrumentation in scoliosis idiopathic (AIS): comparison of midterm clinical, functional and radiologic outcomes. Spine 2004;29:2024-2030.
29. Moen KY, Nachemson AL. Treatment of scoliosis. An historical perspective. Spine 1999;24:2570-2575.
30. Vedantam R, Lenke LG, Bridwell KH, Haas J, Linville DA. A prospective evaluation of pulmonary function in patients with adolescent idiopathic scoliosis relative to the surgical approach used for spinal arthrodesis. Spine 2000;25:82-90.
31. Richards BR, Emara KM. Delayed infections after posterior TSRH spinal instrumentation for idiopathic scoliosis. Spine 1998;26:1990-1996.
32. Rogala EJ, Drummond DS. The Shriner’s flexicurve assessment of scoliotic lump deformities. J Bone Surg 1979;61B:245.
33. Yongjung K, Lenke L, Bridwell K. Pseudarthrosis in primary fusions for adult idiopathic scoliosis: incidence, risk factors, and outcome analysis. Spine 2005;30:468-474.
34. Kunimune Y, Harada Y, Kabutu Y, Takeuchi K, Senda M, Inoue H. Recovery from exercise-induced desaturation in the paraspinal muscles in idiopathic scoliosis. Spine 1999;24:2019-2024.
35. Harris B. The neurological risk of Harrington procedures. Arch Orthop Unfallchir 1975;83:311-322.
36. Wajanavisit W, Laohacharoensombat W. Treatment of adolescent idiopathic scoliosis using Cotrel-Dubousset spinal instrumentation. J Med Assoc Thai 2000;83:146-150.