Feasibility of Single-Stage Posterior Passive Correction and Fusion Surgery for Congenital Scoliosis in Adolescent Patients Who Have Attained Skeletal Maturity

Retrospective study. To report the perioperative and radiological outcomes of single-stage posterior passive correction and fusion (SSPPCF) in adolescent patients who present with congenital scoliosis. The surgical treatment for congenital scoliosis is complex. There is no definitive guide on surgic...

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Published in:Asian spine journal 2022-06, Vol.16 (3), p.315-325
Main Authors: Chiu, Chee Kidd, Tan, Rommel Lim, Gani, Siti Mariam Abd, Chong, Jessamine Sze Lynn, Chung, Weng Hong, Chan, Chris Yin Wei, Kwan, Mun Keong
Format: Article
Language:English
Subjects:
adolescent
Back surgery
Blood transfusion
Clavicle
Clinical Study
congenital
Flexibility
Hemoglobin
Medical records
passive correction
Patients
Sacrum
Scoliosis
spine surgery
Thorax
Tomography
Vertebrae
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Summary:Retrospective study. To report the perioperative and radiological outcomes of single-stage posterior passive correction and fusion (SSPPCF) in adolescent patients who present with congenital scoliosis. The surgical treatment for congenital scoliosis is complex. There is no definitive guide on surgical options for skeletally matured adolescent patients who have congenital scoliosis. Patients with congenital scoliosis who underwent SSPPCF using a pedicle screw system were reviewed. We identified the following three surgical indications: (1) hemivertebra or wedge vertebra over the thoracic or thoracolumbar region with structural lumbar curves, (2) hemivertebra or wedge vertebra at the lumbar region with significant pelvic obliquity or sacral slanting, and (3) mixed or complex congenital scoliosis. The demographic, perioperative, and radiographic data of these patients were collected. Thirty-four patients were reviewed. The mean patient age was 14.6±3.4 years. There were 13 hemivertebrae, three wedged vertebrae, two butterfly vertebrae, three hemivertebrae with butterfly vertebra, eight unsegmented bars, and five multiple complex lesions. The average surgical duration was 219.4±68.8 minutes. The average blood loss was 1,208.4±763.5 mL. Seven patients required allogeneic blood transfusion. The mean hospital stay duration was 6.1±2.5 days. The complication rate was 11.8% (4/34): one patient had severe blood loss, one had rod breakage, and two had distal adding-on. The Cobb angle reduced from 65.9°±17.4° to 36.3°±15.3° (p
ISSN:1976-1902
1976-7846
DOI:10.31616/asj.2020.0649