Isola spinal instrumentation system for idiopathic scoliosis

Since the definition of three-dimensional components of the scoliotic defor mity, there have been important improvements in the surgical treatment of t he problem. A derotation maneuver was proposed as a treatment option with C D instrumentation, but the reports of imbalance and decompensation with thi s system repopularized sublaminar wiring and translation as a corrective ma neuver. Isola spinal instrumentation is one of the modem systems that utili zes vertebral translation instead of rod rotation. This study analyzes the results of 24 patients with idiopathic scoliosis who had been followed up f or at least 2 years, and were surgically treated with titanium Isola Spinal Instrumentation in the Department of Orthopaedics and Traumatology, Ankara Social Security Hospital. Patients were grouped according to the King-Moe classification. Patients with type III, IV or V curves received only poster ior instrumentation while this procedure followed anterior release and disc ectomy in the same session in patients with type I or LT curves. A translat ion maneuver was utilized in the correction of scoliotic curves using the c antilever technique, either alone or supplemented by sublaminar wiring with Songer multifilament titanium cables. This study aimed to elucidate the ef fects of this technique in the frontal and sagittal plane curves and the tr unk balance. The balance was analyzed clinically and radiologically by meas urement of the lateral trunk shift (LT), shift of stable vertebra (SS), and shift of head (SH) in vertebral units (VU). The postoperative correction w as significant in the frontal plane for all types of curves (p < 0.05). The postoperative correction was 80.9% +/- 9.5% in type III curves. Overall, t he mean Cobb angle of the major curve value in the frontal plane was 66.9<d egrees> +/- 18.8 degrees, and it was corrected by 62.8% +/- 20.1%. The corr ection loss of Cobb angles in the frontal plane was 5.4 degrees +/- 5.5 deg rees at the last follow-up visit. A normal physiologic thoracic contour (30 degrees -50 degrees) was achieved in 83.3% of the patients and normal lumb ar contour (40 degrees -60 degrees) in 66.7% of the patients in the sagitta l plane. The correction was found to be significant in all balance values ( p < 0.05). The postoperative correction in LT values correlated with the co rrection of the Cobb angle values in the frontal plane. All patients had co mplete balance (SH: 0 VU and SS: 0 VU) or balanced curves (0 VU < SH, SS < 0.5 VU). Finally, the study concluded that the translation maneuver, especi ally when used with the cantilever technique, resulted in high correction r ates in the frontal plane. Additionally, the technique was also successful in obtaining normal sagittal contours and correcting balance values.