Bae SungSoo, Hyun Seung-Jae, Lee Jae-Koo, Jo Dae-Jean, Kim Ki-Jeong
Department of Neurosurgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea.
Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
J Korean Neurosurg Soc. 2025 Sep;68(5):585-591. doi: 10.3340/jkns.2024.0224. Epub 2025 Mar 20.
This study aimed to evaluate the clinical and radiographic results of patients with adolescent idiopathic scoliosis (AIS) operated by a single neurosurgeon.
A total of 139 consecutive patients with AIS who underwent corrective surgery by a single neurosurgeon were investigated between January 2011 and January 2024. Segmental instrumentation with pedicle screws was utilized for deformity correction. Demographic information, structural type of curve using Lenke classification, degree of correction achieved, total numbers of fusion levels, complications, and clinical/radiographic results were evaluated.
Most patients were adolescent girls (105 vs. 34) with an average age of 15.9 vs. 16.0, respectively. The average duration of follow-up was 4.5 years (0.1-13.0). Nine patients (6.6%) had levoscoliosis, and the remaining 130 had dextroscoliosis. Chiari malformation with syringomyelia was incidentally diagnosed in four patients (2.8%). Of the patients having Chiari malformation, two (50%) had levoscoliosis. The mean number of fused levels was 11.2. The mean value of the Cobb angle of the major structural curvature was 63.4° (43°-125°). The major structural curve's average percentage of correction was 78.8%. The final postoperative SRS-22 average score significantly improved to 4.3±0.4 compared with the preoperative score of 3.8±0.5 (p<0.001). After the surgery, there were no observed cases of neurological deficits or need for screw repositioning. Revision fusion extension surgery was performed on one patient to treat postoperative shoulder imbalance.
Patients with AIS treated by a neurosurgeon had acceptable clinical and radiographic results. However, AIS surgery necessitates a fundamental comprehension of pediatric spinal deformities, which is crucial. Furthermore, spine surgeons should be careful with patients who have levoscoliosis.
本研究旨在评估由单一神经外科医生手术治疗的青少年特发性脊柱侧凸（AIS）患者的临床和影像学结果。
对2011年1月至2024年1月期间由单一神经外科医生进行矫正手术的139例连续AIS患者进行调查。采用椎弓根螺钉节段性内固定进行畸形矫正。评估人口统计学信息、使用Lenke分类的曲线结构类型、实现的矫正程度、融合节段总数、并发症以及临床/影像学结果。
大多数患者为青春期女孩（105例对34例），平均年龄分别为15.9岁和16.0岁。平均随访时间为4.5年（0.1 - 13.0年）。9例患者（6.6%）为左旋脊柱侧凸，其余130例为右旋脊柱侧凸。4例患者（2.8%）偶然诊断出合并脊髓空洞症的Chiari畸形。在患有Chiari畸形的患者中，2例（50%）为左旋脊柱侧凸。平均融合节段数为11.2个。主要结构弯曲的Cobb角平均值为63.4°（43° - 125°）。主要结构曲线的平均矫正百分比为78.8%。术后SRS - 22最终平均评分与术前评分3.8±0.5相比显著提高至4.3±0.4（p<0.001）。手术后，未观察到神经功能缺损或螺钉重新定位的情况。对1例患者进行了翻修融合延长手术以治疗术后肩部不平衡。
由神经外科医生治疗的AIS患者具有可接受的临床和影像学结果。然而，AIS手术需要对小儿脊柱畸形有基本的理解，这至关重要。此外，脊柱外科医生应对左旋脊柱侧凸患者谨慎对待。
