Anterior instrumentation for adolescent idiopathic scoliosis

Thirty-two patients with adolescent idiopathic scoliosis underwent anterior fusion with rigid single rod (third generation instrumentation) and titanium mesh cages. The mean follow-up was 31 (24-45) months and the mean age was 14.9 years. There were 8 patients with King type I, 10 with type II, 6 with type III, 4 with type IV and 4 with lumbar curves. Titanium mesh cages were used in all the lumbar procedures and at the cranial and caudal ends of the instrumented area in thoracic cases. All the patients were immobilized in an orthosis for 3-6 months postoperatively. Mean preoperative primary coronal Cobb angle of 56 degrees was improved to 8.6 degrees. Average correction rate was 84%. Sagittal balance was restored with a mean thoracic kyphosis of 28 degrees and a mean lumbar lordosis of 38 degrees. Spontaneous secondary curve decompensation did not occur and postoperative thoracolumbar junctional kyphosis was not seen. One case had to be revised due to proximal screw pull out and loss of correction.