Research

INTRODUCTION: Anterior instrumented fusions are now commonly used to treat thoracolumbar and lumbar adolescent idiopathic scoliosis. Kyphosis can be a significant complication, but lordosis may be maintained using structural support anteriorly. This study evaluates a lordosis preserving anterior single solid rod fusion technique with structural rib autograft in thoracolumbar and lumbar adolescent idiopathic scoliosis.
METHODS: Fourteen patients (average age 18.1) with AIS were treated by one surgeon with identical anterior surgical technique using 6.0 mm solid rod construct and rib as structural bicortical autogenous bone graft in the anterior aspect of each disc space. No patients were braced postoperatively. Each patient had a minimal follow-up of 2 years. Preoperative, initial postoperative, and final follow-up radiographs were reviewed to compare coronal and sagittal parameters.
RESULTS: Sagittal plane alignment improved in lordosis for each measured parameter and physiologic lordosis was maintained. There were no pseudarthroses, reoperation, or instrumentation failures.

CONCLUSION: Anterior single solid rod instrumentation in thoracolumbar and lumbar adolescent idiopathic scoliosis with structural autogenous rib graft maintains physiologic lumbar lordosis at 2 years following surgery. There is no additional cost when compared to allograft or mesh cages.