Solid rod short segment anterior fusion in thoracolumbar scoliosis

Seventeen patients with adolescent idiopathic thoracolumbar scoliosis underwent short segment anterior spinal fusion with a solid rod-screw construct. Patients were evaluated radiographically and interviewed using the Scoliosis Research Society instrument. Mean radiographic follow-up was 34 months, and mean follow-up at time of interview was 62 months. Mean curve correction was 87%, declining to 67% at 2 years. Mean correction of the instrumented curve was 114%, declining to 103% at 2 years. The thoracic curve improved 24% and remained stable throughout the follow-up period. Kyphosis over the instrumented segments increased from 4 degrees preoperatively to 10 degrees postoperatively. Although there was a trend toward increasing kyphosis over time, this was not statistically significant at final follow-up. Most patients (88%) were extremely satisfied with the surgical result. We believe that a short-segment anterior fusion with a solid rod-screw construct provides excellent curve correction with minimal kyphosis over the instrumented segment. Overcorrection of the instrumented segment must be achieved for this technique to be successful.