| Objective To study the early efficacy and safety of concave distraction technique in the treatment of severe rigid idiopathic scoliosis. Methods The clinical data of 8 patients with severe rigid scoliosis admitted and operated in the Second Hospital of Shanxi Medical University from January 2020 to December 2022 were analyzed retrospectively. During operation, one short rod was implanted into the concave side and distended, and then double long rods were implanted in bilateral sides. Main curve Cobb angle, compensatory curve Cobb angle, thoracic kyphosis (TK), lunbar lordosis (LL), apex vertebra translation (AVT) and trunk shift (TS) were measured through standing posterior-anterior (PA) X-ray pre-operatively, post-operatively and at the final follow-up. Results The patients were followed up for (9.0±6.3) months (1-16 months). The main curve, compensatory curve, thoracic kyphosis, lumbar lordosis, AVT and TS were 97.4°±10.0°, 55.6°±8.4°, 50.4°±20.3°, 62.7°±6.3°, (7.64±1.55) cm and (2.00±1.93) cm preoperatively, which were improved to 25.8°±8.1°, 21.0°±12.0°, 24.9°±9.6°, 31.6°±11.9°, (2.34±1.45) cm and (1.26±0.63) cm postoperatively, and 21.2°±9.1°, 22.4°±16.1°, 32.8°±12.0°, 37.6°±14.0°, (2.41±0.81) cm and (1.6±1.4) cm at the last follow-up. Except TS, the values of the other indicators mentioned above at the immediate and last follow-up after operation were significantly different from those before operation (P＜0.05), but there was no statistically significant difference in the values between the immediate and last follow-up after operation (P＞0.05). One patient developed delayed infection 7 months after surgery, and then healed again after surgical debridement and internal fixation removal. Conclusion Treatment of severe rigid scoliosis with the distraction on concave side can achieve satisfactory orthopedic effect, less bleeding and low incidence of intraoperative and postoperative neurological complications. It is a safe, effective and practical treatment method. |
