A1 Refereed original research article in a scientific journal
Posterior Spinal Fusion Extended to Stable Vertebra Provides Similar Outcome in Juvenile Idiopathic Scoliosis Patients Compared with Adolescents with Fusion to the Touched Vertebra
Authors: H. Oksanen, M. Lastikka, L. Helenius, O. Pajulo, I. Helenius
Publisher: SAGE Publications Inc.
Publication year: 2019
Journal: Scandinavian Journal of Surgery
Journal name in source: Scandinavian Journal of Surgery
Volume: 108
Issue: 1
First page : 83
Last page: 89
Number of pages: 7
ISSN: 1457-4969
DOI: https://doi.org/10.1177/1457496918798193
Background and Aims: To compare outcomes between posterior spinal fusion of juvenile
idiopathic scoliosis and adolescent idiopathic scoliosis patients with a minimum of 2-year
follow-up. The juvenile idiopathic scoliosis patients were fused to the stable vertebra and
adolescent idiopathic scoliosis to the touched vertebra. We hypothesized that extending
the spinal fusion to the stable vertebra in juvenile patients would provide similar outcomes
compared with fusion to the touched vertebra in adolescents.
Materials and Methods: A prospective comparative study of 21 consecutive children with
juvenile (Risser 0) and 84 adolescent (Risser ⩾2) idiopathic scoliosis (1:4 ratio) undergoing
bilateral segmental pedicle screw instrumentation and direct vertebral derotation with a
minimum of 2-year follow-up.
Results: Juvenile patients had a significantly larger main curve (58° vs 53°, p = 0.003),
more fused levels (p = 0.012) and posterior column osteotomies (p = 0.014) than adolescent
patients. Distal adding-on (>10°) was observed in one (4.7%) juvenile and three (3.6%)
adolescent patients (p = 0.80), without the need for revisions. Scoliosis Research Society
24 total score averaged 101 in juvenile and 97 in adolescent group at 2-year follow-up
(p = 0.047).