Pediatric Orthopaedics Journal Scan

Safety and Efficacy of Instrumented Convex Growth Arrest in Treatment of Congenital Scoliosis.

J Pediatr Orthop. 2013 Sep 15;

Authors: Demirkiran G, Yilmaz G, Kaymaz B, Akel I, Ayvaz M, Acaroglu E, Alanay A, Yazici M

Abstract
BACKGROUND:: Anterior and posterior convex hemiepiphysiodesis is a widely used surgical alternative in the treatment of congenital scoliosis. This procedure has the disadvantage of the need for both anterior and posterior approaches. Furthermore, outcomes may be unpredictable. Posterior convex growth arrest (CGA) with pedicle screws at each segment on the convex side may obviate the need for anterior surgery and provides more predictable outcomes. This study retrospectively evaluates the safety and efficacy of instrumented posterior CGA in congenital scoliosis.
METHODS:: Patients who had posterior CGA with convex pedicle screw instrumentation for congenital scoliosis were evaluated retrospectively. Thirteen patients (6 male, 7 female) were included in the study. Preoperative, early postoperative, and last follow-up standing posteroanterior and lateral x-rays were evaluated. Cobb angles were recorded for the instrumented segment (main curve). Global thoracic kyphosis was measured between T2 and T12 on sagittal plane. These values were compared preoperatively, postoperatively, and at last follow-up. The T1-S1 vertical height and the height between the concave side pedicles of the upper and lower end vertebra of the main curve was also determined and recorded as the concave height.
RESULTS:: The average follow-up was 56.1±10 months (range, 36 to 74 mo) and the average age of the patients at the time of operation was