ABSTRACT

Purpose:

To evaluate the effectivity of Ponte’s osteotomy in the patients of adolescent idiopathic scoliosis (AIS) with rigid curvature.

Method:

From 74 patients having severe structural scoliosis, the patients who have curvature above 50° and in whose curvature graphies recovery less than 45 % was ensured and Ponte’s osteotomy was applied to different number of levels. From these patients, 23 patients who were followed up for 2 years and above and were included to the study. The surgical details, the complications and the estimated blood loss were recorded. The corrections on the coronal and sagittal plane were radiologically measured and the Scoliosis Research Society-22 survey was applied to the patients.

Results:

According to the measurements made preoperatively, the Cobb angle of the main thoracic curvature on the coronal plane was measured as 70.9o (45°-93°) in average and the Cobb angle of the thoracolumbar/lumbar curvature was measured as 520 (16°-99°) in average; in the fulcrum curvature graphies, the flexibility rate was calculated as 36.8 % in the thoracic curvatures and as 32.4 % in the thoracolumbar/ lumbar curvatures. In the coronal measurements made after Ponte’s osteotomy was applied to our patients at the level of 3.1 (2-7) in average, the main thoracic curvature was calculated as 23.4° and the thoracolumbar curvature was calculated as 18.6° (p<0.001). In the measurements made on the sagittal plane, on the other hand, the values found are not statistically significant even though they are successful.

Conclusions:

In the rigid AIS patients, Ponte’s osteotomy helps to the correction procedure made with pedicle screws. It is an effective and reliable method that can be used in order to increase the correction amount in the rigid AIS patients even though it increases the bleeding amount and the operation period.