Segmental scoliosis correlation: use of the Lea Plaza Frame

Patients with adolescent idiopathic scoliosis that underwent spine fusion using the principle of segmental correction and a specific instrumentation.

Evaluation of the methodology used.

The results of surgical correction of scoliosis today are mainly related to the popular use of the CD and other similar instrumentations. Most of its users report that the corrective mechanisms allow coronal and sagittal correction of the deformed spine but not derotation in the horizontal plane. The results of a corrective methodology using segmental correction are reviewed here to evaluate triplanar correction of the deformity.

Two hundred seventy-three adolescents with idiopathic scoliosis underwent corrective arthrodesis with the Lea Plaza Frame at the average age of 15.2 years. Coronal and sagittal values were measured with the Cobb method, rotation with the Pedrialle ruler. Trunk, shoulder imbalance and the rib prominence was documented by plain pictures. Follow-up average is 7.8 years.

Preoperative: Coronal curves averaged 54 degrees. Associated preoperative thoracic hypokyphosis = 8 degrees. Lordosis = -3 degrees. Hyperkyphosis = 56 degrees. Apical rotation was 23 degrees. Postoperative: Long-term values: corrected coronal curves measured 20 degrees, hypokyphosis decreased to 23 degrees, and lordosis reversed to 18 degrees, whereas hyperkyphosis decreased to 41 degrees. Apical derotation is 31%. Of the patients with preoperative trunk imbalance over the pelvis, 95% were completely corrected and the 98% with shoulder unleveled had also full correction of these phenomena.

This review shows that tridimensional correction in flexible curves can be obtained by following the principle of segmental correction.