Dynamic stabilization in adolescent idiopathic scoliosis with a 5-year follow-up: a case report

Although instrumented fusion is the most widely accepted surgical treatment for adolescent idiopathic scoliosis, it leads to permanent spinal motion loss and an increased risk of adjacent segment degeneration. Consequently, there is great interest in finding nonfusion methods to correct scoliosis in patients with adolescent idiopathic scoliosis. The aim of this manuscript is to report a case of adolescent idiopathic scoliosis (Lenke 5C) treated by dynamic stabilization without fusion using the Dynesys system.

The patient was a 17-year-old East Asian female. Before the operation, the major lumbar curve was 32.2° and the lumbosacral curve was 18.5°, with the Risser sign at grade 4. The procedure was performed using the Wiltse approach. The extent of fixation was from the cephalic horizontal vertebra to sacrum. The scoliosis was corrected by the unequal length of the spacers on the concave/convex side. We obtained a good correction of scoliosis, which was maintained during the 5-year follow-up. We also observed less intraoperative blood loss, faster postoperative recovery, and more motion preservation.

In this case, dynamic stabilization was demonstrated to be technically feasible for the treatment of thoracolumbar/lumbar moderate scoliosis. The benefits are related to less damage to the soft tissues, reduced blood loss, and motion preservation. However, further studies are needed to determine the effectiveness of the described surgical strategy.