Comparison of Two Surgical Methods for Treatment of Idiopathic Thoracic Scoliosis - Anterior versus Posterior Approaches
Abstract
The aim of this retrospective randomised study is a comparison of two surgical approaches (anterior versus posterior) for the treatment of idiopathic thoracic scoliosis by corrective spondylodesis with segmental instrumentation in adolescents aged 13 to 20 years. The study included patients with right-sided idiopathic thoracic scoliosis (Cobb's angle, 40o-70o; Lenke type I).
The group of patients treated from the posterior approach by fusion and segmental instrumentation, involving the use of a hybrid, two-rod system or screws only, comprised 31 girls with an average age of 14.5 years (group 1). In this group three instrumentation systems were used.
The patients treated from the anterior approach, which included thoracotomy for disc excision, fusion and segmental instrumentation with a one- or two-rod system, consisted of 25 girls and six boys with an average age of 15.3 years (group 2). In this group four instrumentation systems were employed.
In all patients radiographs were evaluated before surgery, immediately after the procedure and then every 12 months. The evaluation also included the operative time, blood loss, length of hospital stay, hospital costs and complications.
The paired t-test or non-parametric paired Wilcoxon's test was employed for testing two variables within each group. In the frontal plane, thoracic kyphosis corrections through either surgical approach are comparable; in the sagittal plane, surgery from the posterior approach results in reducing thoracic kyphosis and that from the anterior approach produces a mild increase in it.