Surgical treatment of adult idiopathic scoliosis: long-term clinical radiographic outcomes.

By London Spine

Surgical treatment of adult idiopathic scoliosis: long-term clinical radiographic outcomes.

Orthopedics. 2011 Mar;34(3):180

Authors: Li M, Shen Y, Gao ZL, Fang XT, Xie Y, Wang CF, Zhao YC, Zhu XD

More adults are suffering from adult idiopathic scoliosis and seeking treatment for their spinal deformities. Adult idiopathic scoliosis can lead to painful spinal osteoarthritis, progressive deformity, spinal stenosis with radiculopathy, muscle fatigue from coronal and sagittal plane imbalance, and psychological effects with a visible deformity. Primary treatment of such conditions is conservative; however, some patients are resistant to conservative treatment or are not candidates for it, and they require surgery. Back pain is likely the most common indication for surgical treatment of scoliosis in adult patients. Pedicle screws offer 3-column purchase and a longer arm compared with hook placement on the lamina. This study is a retrospective analysis of a consecutive series of patients with adult idiopathic scoliosis who were treated with pedicle screw placement. Significant back pain relief and satisfaction can be achieved and maintained over the long term. Restoration of coronal and sagittal balance, or improvement thereof, was achieved in all patients with balance problems. This study clarified several important characteristics of adult scoliosis, and we believe that useful conclusions can be drawn regarding its surgical indications and strategies: (1) pedicle screw construct can gain effective results for treatment of adult idiopathic scoliosis due to its perceived superior power of correction; (2) younger patients present for surgery for different reasons than older patients (progressive deformity or pain); and (3) pain improvement is a more reliable outcome in older patients than younger patients, although younger patients rarely have severe pain symptoms.

PMID: 21410122 [PubMed – indexed for MEDLINE]

Surgical treatment of adult idiopathic scoliosis – comparison of two instrumentations.

By London Spine

Surgical treatment of adult idiopathic scoliosis – comparison of two instrumentations.

Int Orthop. 2002;26(4):207-10

Authors: Wang ST, Ma HL, Lin CF, Liu CL, Yu WK, Lo WH

In this study, 22 women patients with adult idiopathic scoliosis treated surgically with Cotrel-Dubousset instrumentation (CDI) or Texas Scottish Rite Hospital instrumentation (TSRHI) were followed up for 56.2+/-4.0 months. The overall immediate and final corrections were respectively 21.5+/-40 (58%) and 26.6+/-2.90 (48%), giving a loss of correction of 5.1+/-1.00 (10%). No significant differences were found in these two parameters between the two groups. The functional outcomes were good in 21 patients. There was no difference between CDI and TSRHI in deformity correction.

PMID: 12185520 [PubMed – indexed for MEDLINE]