ABSTRACT

Significant correction can be achieved through both anterior and posterior instrumented spinal fusion in the treatment of adolescent idiopathic scoliosis. However, there are only a few studies comparing two methods applied to similar curves. Radiographic and medical records of 40 patients treated by either anterior or posterior instrumented spinal fusion for Lenke I type curves were reviewed. 20 patients underwent anterior surgery at an average age of 14.4 years and 20 others underwent posterior surgery at an average age of 15.4 years. Standing AP and lateral roentgenograms were evaluated. Frontal and sagittal Cobb angles, apical vertebral transposition (AVT), apical vertebral rotation (AVR), C7-CVSL shift, trunk shift and number of fused segments were compared. Changes in scoliosis correction parameters were compared using student’s t-test. Two groups were similar regarding age, gender, magnitude and flexibility of curves. Preoperative average coronal curve of 55.2±9.3° was corrected to 18.7°± 9.8° (66 % correction) in the anterior group while average coronal curve of 60.6° ± 9.8° was corrected to 25.6° ± 8.5° (57 % correction) in the posterior group (p<0.05). Correction of trunk shift and AVR was also significantly better in the ASFgroup. The number of fused segments were 7.4 in the anterior and 9.1 in the posterior group. No significant difference was observed regarding the thoracic kyphosis, AVT and C7-CVSL shift. No pseudoarthrosis occured in either group. Anterior instrumented spinal fusion provided better correction of coronal curve, apical vertebral rotation and trunk shift through fusion of lesser segments.