OBJECTIVE: To analyze the corrections obtained by selective thoracic segmental instrumentation using pedicle screws in patients with idiopathic scoliosis with lumbar B or C modificators. Determine the safety of the technique and decompensation of non-instrumented and instrumented compensatory curves. Observe the loss of the correction of instrumented and non-instrumented curves over the time. METHODS: Retrospective study of patients with idiopathic scoliosis curves types 1B, 1C, 2B and 2C who underwent surgical treatment via posterior approach using pedicle screws. The variables analyzed were: sex, age, levels affected by scoliosis, instrumented levels, number of inserted pedicle screws, classification according to Lenke, pre-surgical coronal and sagital Cobb angles (inclination included), immediate and late postoperative Cobb angles and the loss of the curve correction over the time. Twenty patients with idiopathic scoliosis underwent surgical selective treatment from August 2004 to October 2007. Eighteen of these patients were followed up and were included in this study they fulfilled the inclusion criteria. RESULTS: The average Cobb angle preoperatively was 52,61º, in the immediate postoperative, it was 17,89º and in the later postoperative, the Cobb angle was 22,15º, with an immediate mean correction of 34,72º and average correction loss of 4,26º at 39,78 months. An immediate average spontaneous correction of 22,62° was obtained in the non-instrumented compensatory curves and an average loss of 2,72º of this correction occurred at 39,78 months. There were no neurological complications, infections or decompensation of the lumbar curves. CONCLUSION: All patients showed substantial improvement in aesthetic terms, as well as in clinical and radiological aspects. Partial loss of correction occurred with time, but they did not lead to decompesation of non-instrumented curves. This study shows evidence of efficacy and safety of selective surgical treatment of idiopathic scoliosis using pedicle screws in the medium and long term.
Scoliosis; Spinal fusion; Spine diseases; Spinal curvatures
