Double Screw-Line Technique of Anterior Scoliosis Correction with Thoracic Disc Releases for Thoracic Curves > 65 Degrees: Surgical Techniques and Outcomes

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Published Jul 22, 2023
DOI: https://doi.org/10.18103/mra.v11i7.1.4095

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Main Article Content

M. Darryl Antonacci, MD
Institute for Spine & Scoliosis, Lawrenceville, NJ, USA
Anthony Yung, MMSc
Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
Ashleigh Kozicz, MPH/PA-C
Institute for Spine & Scoliosis, Lawrenceville, NJ, USA
Janet Cerrone, PA-C
Institute for Spine & Scoliosis, Lawrenceville, NJ, USA
Christopher L. Antonacci, MD
Dept. of Orthopaedic Surgery, UConn Health, Farmington, CT, USA
Yashvi Verma
Institute for Spine & Scoliosis, Lawrenceville, NJ, USA
Madeline Sweeney, APN
Institute for Spine & Scoliosis, Lawrenceville, NJ, USA
Laury A. Cuddihy, MD
Institute for Spine & Scoliosis, Lawrenceville, NJ, USA
Randal R. Betz, MD
Institute for Spine & Scoliosis, Lawrenceville, NJ, USA

Abstract

Anterior Scoliosis Correction (ASC) is the proprietary technique of the authors and is an anterior spinal “de-tethering” technique using multiple flexible rod-cords and multiple screw constructs. It is performed through a modified anterior fusion approach that is a muscle-sparing mini-thoracotomy. ASC is the multi-year (since 2013), multi-generational modification of the original anterior vertebral body tethering procedure but includes preservation of the segmental arteries and incorporates multilevel releasing techniques of the contracted anterior longitudinal ligament and annular disc complex. Because of this, ASC, unlike vertebral body tethering, has been shown to derotate the hypokyphotic scoliotic spine effectively towards a more normal thoracic kyphosis and is not restricted to small curves or pediatric patients with growth remaining as is vertebral body tethering.


We retrospectively reviewed all 309 ASC procedures performed between September 2017 and August 2020, and 26 patients met the inclusion criteria (adolescent idiopathic scoliosis and at least a thoracic operative curve with severe coronal curve angles between 66° and 90°, double screw and rod-cord construct, and minimum 2-year follow-up).


The results of ASC on severe curves showed an average curve correction of 78.4% in thoracic and 71.2% in lumbar curves in the instrumented curves. Anterior longitudinal ligament and annular disc complex releases were performed on all patients having thoracic curves to help obtain adequate correction. An average of 4.1 discs per patient were released, all in the thoracic region. Clinical success with residual curves ≤ 35° was 96% (25/26 curves) in all patients and 92.3% in patients with curves ≤ 30° (24/26 curves). Three-dimensional (3D) thoracic kyphosis corrected an average of 39° from preoperative hypokyphosis of -4° to 35° postoperatively. There were no revisions performed in this group of patients.


In conclusion, Anterior Scoliosis Correction has potential expanded indications and increased ability to correct severe curves (> 65°) in patients with adolescent idiopathic scoliosis as compared to vertebral body tethering.

Keywords: Anterior Scoliosis Correction, Adolescent Idiopathic Scoliosis, Anterior Vertebral Body Tethering, Kyphosis Restoration, Severe Curve

Article Details

How to Cite
ANTONACCI, M. Darryl et al. Double Screw-Line Technique of Anterior Scoliosis Correction with Thoracic Disc Releases for Thoracic Curves > 65 Degrees: Surgical Techniques and Outcomes. Medical Research Archives, [S.l.], v. 11, n. 7.1, july 2023. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/4095>. Date accessed: 21 nov. 2024. doi: https://doi.org/10.18103/mra.v11i7.1.4095.
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Issue
Vol 11 No 7.1 (2023): July Issue, Vol.11, Issue 7.1
Section
Research Articles

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