• Eur Spine J · Apr 2022

    Multicenter Study

    Comparison of four correction techniques for posterior spinal fusion in adolescent idiopathic scoliosis.

    • Sebastien Pesenti, Jean-Luc Clément, Brice Ilharreborde, Christian Morin, Yann Philippe Charles, Henri François Parent, Philippe Violas, Marc Szadkowski, Louis Boissière, Jean-Luc Jouve, and Federico Solla.
    • Pediatric Orthopedics, CHU Timone, Aix MArseille University, Marseille, France. seb.pesenti@gmail.com.
    • Eur Spine J. 2022 Apr 1; 31 (4): 1028-1035.

    IntroductionWhen performing posterior spinal fusion for adolescent idiopathic scoliosis (AIS), it is of major importance to address both coronal and sagittal deformities. Although several techniques have been described, few data exist comparing them. Our objective was to compare four techniques (in situ bending (ISB), rod derotation (RD), cantilever (C) and posteromedial translation (PMT)) for the correction of spinal deformity in AIS including thoracic deformity.Material And MethodsWe conducted a multicenter retrospective study including 562 AIS patients with thoracic deformity with at least 24-month follow-up. Radiographic analysis was performed preoperatively, postoperatively and at last follow-up. The main outcomes were main curve correction and thoracic kyphosis restoration (TK).ResultsCoronal correction rate was significantly different among the four treatment groups (ISB 64% vs C 57% vs RD 55% vs PMT 67%, p < 0.001). Multivariate regression revealed that correction technique did not influence correction rate, whereas implant density, convex side compression and use of derotation connectors did. TK increase was significantly higher in the PMT group (average + 13°) than in DR (+ 3°), while ISB (-3°) and cantilever (-13°) resulted in TK decrease (p < 0.001). Multivariate analysis revealed that TK increase was only influenced by the reduction technique (p < 0.001) and preoperative TK (p < 0.001).DiscussionThe four techniques had the same ability to correct spinal deformity in the coronal plane. Three factors were identified to improve correction rate: implant density, convex compression and use of derotation connectors. On the other hand, PMT was more effective in restoring TK, particularly in hypokyphotic patients.© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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