O2533 PRESERVING THE LUMBAR SEGMENTS IN SINGLE STAGE ANTERIOR SURGERY OF DOUBLE SCOLIOTIC CURVES

Abstract

Double scoliotic curves usually demand long posterior fusion and limitation of lumbar motion. The purpose of the study was to determine a possibility of one stage surgery, 3D correction, balanced spine and maximum of lumbar mobility. Method: 47 patients in the age of 14±1.6 yrs with double IAS curves were operated from 1995–99 with an average follow up of 50±9 months. Untill 1998 all the patients (31) were fused from Th4 to Th12, leaving the fused curve in balance with compensatory lumbar curve (group1). From 1998–00, 16 patients underwent a single stage anterior surgery of boh curves from Th4-L3 if lower curve averaged 50û (group 2). Two independent observers analyzed the results. Results: G1 (Th 67û±10;L41û±11) was corrected to Th19û±4; L17û±4. Balance changed from 11 mm pre op. to 2.4 mm post op. However, 6 patients (avr. 70û+60û), were corrected to 25û+38û. One year of bracing was necessary to partially correct the disballance, with satisfactory overall results. In 3 patients (Th> 80, L> 50) a balanced spine resulted, but with problematic correction rate. In G2, correction was made from Th68û±17;L63û±10û, to Th23û±12;L21û±8. Mean op. time was 260 min., blood loss 640 ml, post.op. stay 12 days. Conclusion: Fusion down to Th12 showed good results if Th< 80 and L< 50 degrees. In greater curves, an extended single stage fusion down to L3 offered better overall results, better correction, no balance problems and good lumbar mobility.