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Journal of Turkish Spinal Surgery, vol.32, no.3, pp.105-110, 2021 (Scopus)
Objective: The aim of this study was to present the long-term results of posterior spinal fusion (PSF) with pedicle screws only for rigid large thoracic curves by questioning, whether this approach could yield sufficient radiographic correction together with good clinical outcomes. Materials and Methods: Patients, who had rigid large thoracic curves and underwent PSF with pedicle screws only between 1993 and 2016 in a single center were retrospectively reviewed. Patients were radiographically evaluated by using standard posteroanterior whole body standing X-rays and side bending X-rays. Functional evaluation was performed by using SRS-22 scores. Results: Fifty-eight patients with an average age of 16.7 and an average follow-up duration of 131.6 months were included. Rigid scoliotic curves of the study population were further subcategorized as: idiopathic (n=50), congenital (n=6), and neuromuscular (n=2) with an average flexibility of 21.7%. Average number of fused segments was 14.2. Patients had an average pre-operative major curve magnitude of 96° (range; 82°-122°) which was improved to 28° (range; 16°-52°) (p<0.001) at the last follow-up visit. An average pre-operative shoulder asymmetry of 3.2 cm in 23 patients was improved to 0.7 cm (p<0.001). An average pre-operative pelvic asymmetry of 3.6 cm in 16 patients was improved to 1.0 cm (p<0.001). Total SRS scores and the scores of all of SRS domains were noted to be improved significantly at the last follow-up. Conclusion: Rigid thoracic scoliotic curves could be corrected with PSF with pedicle screws only, with high success and low rates of complications. By utilizing PSF to rigid thoracic curves, the possible complications of anterior surgery could be avoided, while highly successful clinical and functional outcomes could be obtained in the long-term.