Anterior instrumentation for adolescent idiopathic scoliosis

Thirty-two patients with adolescent idiopathic scoliosis underwent anterior fusion with rigid single rod (third generation instrumentation) and titani um mesh cages. The mean follow-up was 31 (24-45) months and the mean age wa s 14.9 years. There were 8 patients with King type I, 10 with type II, 6 wi th type III, 4 with type IV and 4 with lumbar curves. Titanium mesh cages w ere used in all the lumbar procedures and at the cranial and caudal ends of the instrumented area in thoracic cases. All the patients were immobilized in an orthosis for 3-6 months postoperatively. Mean preoperative primary c oronal Cobb angle of 56 degrees was improved to 8.6 degrees. Average correc tion rate was 84%. Sagittal balance was restored with a mean thoracic kypho sis of 28 degrees and a mean lumbar lordosis of 38 degrees. Spontaneous sec ondary curve decompensation did not occur and postoperative thoracolumbar j unctional kyphosis was not seen. One case had to be revised due to proximal screw pull out and loss of correction.