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Skip pedicle screw fixation combined with Ponte osteotomy for adolescent idiopathic scoliosis
Jun Takahashi1, Shota Ikegami, Shuugo Kuraishi
1Departments of Orthopaedic Surgery, School of Medicine, Shinshu University, Matsumotoshi Asahi 3-1-1, Nagano, 390-8621, Japan, jtaka@shinshu-u.ac.jp.
Purpose:
This study aimed to determine whether Ponte osteotomy combined with skip pedicle screw fixation (SPSF) can improve the correction rate and restore thoracic kyphosis for patients with adolescent idiopathic scoliosis.
Methods:
Surgical time, blood loss, preoperative Cobb angle of the main thoracic curve, flexibility, Cobb angle at 1 year after surgery, thoracic curve correction rate, and Cincinnati correction index (CCI) were determined for both the Ponte (n = 17) and non-Ponte (control; n = 21) groups. Furthermore, kyphotic angles at T5-T12 before and 1 year after the surgery were measured.
Results:
The following measurements were obtained for the Ponte and control groups, respectively: surgical time, 236 ± 13 and 187 ± 9 min; blood loss, 1,141 ± 150 and 745 ± 120 g; preoperative Cobb angle of the main thoracic curve, 52.5° ± 10.4° and 51.5° ± 9.2°; flexibility, 31.7 ± 13.2 and 45.1 ± 12.3% (p = 0.003); thoracic curve correction rate, 62.0 ± 2.5 and 63.6 ± 2.5%; CCI, 2.2 ± 0.2 and 1.5 ± 0.1 (p = 0.003); preoperative kyphotic angle at T5-T12, 11.3° ± 11.2° and 13.0° ± 9.0°; and kyphotic angle at T5-T12 at 1 year after the surgery, 21.8° ± 1.7° and 24.2° ± 1.9°.
Conclusion:
Ponte osteotomy was combined with SPSF in case of rigid curve. CCI was significantly greater in the Ponte group. Postoperative thoracic kyphotic angles were identical in both groups.
