91 - Retrospective Review of Anterior Scoliosis Correction (ASC) for Thoracic Curves >65º: Surgical Techniques and Outcomes

Saturday, June 3, 2023

12:10 PM – 12:12 PM

Location: Salons 10-12

Co-Author(s)

MA

M Darryl Antonacci

United States
AY

Anthony Yung

United States
AK

Ashleigh Kozicz

United States
JC

Janet Cerrone

United States
CA

Christopher Antonacci

United States
YV

Yashvi Verma

United States
MS

Madelyn Sweeney

United States
LC

Laury Cuddihy

United States

Presenting Author (Person doing the Podium Present(s)

rB

randal R. Betz, MD

Pediatric Scoliosis and Spine Surgeon
Institute for Spine & Scoliosis
Lawrenceville, New Jersey, United States

Submitter(s)

rB

randal R. Betz, MD

Pediatric Scoliosis and Spine Surgeon
Institute for Spine & Scoliosis
Lawrenceville, New Jersey, United States

Disclosure(s):

randal R. Betz, MD: No relevant disclosure to display

Introduction: Anterior Scoliosis Correction (ASC) surgery is the proprietary technique of the authors and is an anterior spinal “de-tethering” technique using multiple flexible cords and multiple screw constructs. It is performed through a modified anterior fusion approach that is a muscle-sparing mini-thoracotomy. ASC is the multi-year (since 2014), multi-generational modification of the original anterior vertebral body tethering (aVBT) but includes preservation of the segmental arteries and multi-level releasing techniques of the anterior longitudinal ligament and annular disc complex. Because of this, ASC, unlike aVBT, has been shown to derotate the hypokyphotic, scoliotic spine effectively towards a more normal thoracic kyphosis and is not restricted to small curves or pediatric patients with growth remaining as is aVBT.
Aims/

Objectives: To review the outcomes of a cohort of both skeletally immature and mature AIS patients with curves >65 who underwent ASC using a double screw/cord construct.

Methods: Retrospective review of all ASC procedures (309 ASC cases) performed between September 2017 and August 2020. 26 patients met the inclusion criteria comprising a diagnosis of Adolescent Idiopathic Scoliosis (AIS) and at least a thoracic operative curve with severe coronal curve angles between 66° and 90°, double screw and cord construct, and minimal 2 year follow up.

Results: The results of non-metal rod fusion ASC on severe curves showed average curve correction of 79.2% in thoracic and 60.3% in lumbar curves. Anterior longitudinal ligament and annular disc complex release technique proprietary to the authors was performed in all patients having thoracic curves to help obtain adequate correction. Clinical success with residual curves ≤ 35° was 96% (25/26). 3D thoracic kyphosis corrected an average of 39° from preoperative hypokyphosis towards normality. There were no revisions performed in this cohort.

Conclusions: ASC has potential expanded indications and increased ability for correction in severe curves (>65°) in patients with AIS.