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Surgical treatment of adolescent severe stiff idiopathic scoliosis with combined anterior and posterior approach – a prospective cohort study

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Author(s): Ketan Khurjekar, A.K. Shyam, Vivek Sharma, K. Keskar, P. K. Sancheti

Journal: Journal of Orthopaedics
ISSN 0972-978X

Volume: 6;
Issue: 4;
Date: 2009;
Original page

Keywords: adolescent scoliosis | anterior release and posterior instrumentation | severe stiff idiopathic scoliosis

ABSTRACT
Background: The main purpose of this study was to assess the results of surgical treatment of severe and stiff adolescent idiopathic scoliosis with combined anterior-posterior approach in terms of correction of deformity radiologically in coronal and sagittal plane, clinically with SRS scoring and associated complications.Materials and methods: A prospective study of clinical and radiological outcome of 32 patients with adolescent idiopathic scoliosis, treated surgically during February 2006 to June 2008 with combined approach (anterior release and posterior instrumentation) was performed. Preoperative evaluation in the form of plain anterior, posterior and lateral bending films and MRI spine to rule out any congenital anomaly were performed. All of these patients had Cobb’s angle > 60 with average being 73°± 13.4º and stiff scoliosis. Single stage surgery was performed in all these patients with anterior release, deformity correction and posterior instrumentation in form of either a hybrid system with proximal hooks and distal pedicle screws or total pedicle screw construct. Multiple radiographic assessments on preoperative, immediate postoperative and final postoperative radiographs and scoring according to SRS-22 scoring system were performed. The data was analysed using paired t test with p value
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