Fusionless surgery for scoliosis: 2-17 year radiographic and clinical follow-up

Study Design. Descriptive case series. Objective. To determine whether fusionless, multiple vertebral wedge osteotomy can safely obtain correction of the deformity with adolescent idiopathic scoliosis (AIS). Summary of Background Data. To our knowledge, no such attempts to manage the AIS with fusionless, vertebral osteotomies have been reported. Methods. A total of 20 consecutive patients were treated since 1987. Deformity correction, complications, respiratory function, and patient-oriented outcome were investigated. Results. There were 20 patients (17 females and 3 males), including 19 with idiopathic and 1 with syringomyelia scoliosis, who underwent surgery at an average age of 16.4 years and were followed for 8.9 years (range 2-17) on average. There were no neurologic complications. One superficial wound infection necessitated debridement. There were 2 patients converted to posterior instrumentation surgery because of deterioration of the deformity. The average Cobb angle of 64.0 degrees before surgery was corrected to 48.2 degrees at 8.9 years after surgery. Decline of the pulmonary function test after surgery was not statistically significant. The patients' responses to questions about function and pain were favorable. Conclusion. Deformity with AIS was safely corrected with fusionless, multiple vertebral wedge osteotomy.