Clinical and radiological outcomes of the multilevel Ponte osteotomy with posterior selective segmental pedicle screw constructs to treat adolescent thoracic idiopathic scoliosis

Abstract

Background: To compare the clinical and radiological outcomes of the surgical correction of Lenke type 1 to 4 scoliosis by using a multilevel Ponte osteotomy procedure with posterior selective segmental pedicle screw constructs or posterior release and selective segmental pedicle screw constructs only in patients with adolescent thoracic idiopathic scoliosis. Methods: Retrospective analysis of 65 patients, 32 treated with the multilevel Ponte procedure (Group A) and 33 with posterior soft tissue release only (Group B). The groups were compared with regard to the change in spinal alignment from preoperative to postoperative assessment and over the follow-up period. Results: A correction rate of the main thoracic curve of 63.9±4.5% was obtained for group A and 65.2±2.4% for group B (P=0.17). However, the Cincinnati correction index was greater for group A (1.8±0.3) than that for group B (1.4±0.2, P<0.001), with a smaller change in angle over the period from 1week postoperatively to the 2-year follow-up (P<0.05). The operative time, volume of blood loss, and volume of transfusion were greater for group A than for group B (P<0.05). Conclusion: The multilevel Ponte osteotomy procedure, with posterior selective segmental pedicle screw constructs, improves the Cincinnati correction index and restores the thoracic kyphosis in patients with adolescent thoracic idiopathic scoliosis.