الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
There are many treatment options available for treatment of rigid adolescent idiopathic cases, these options could be summarized, with regard to approach, into combined anteroposterior and posterior only approach.
Comined anteroposterior entails opening of the thorax to access the spine anteriorly while posterior only approach entails approaching the spine posteriorly without opening the thorax.
The major disadvantages of combined anterior release and posterior instrumentation procedures are: Increase in surgery time, increase in cost of surgery, increase of blood loss and alterations of pulmonary functions, as a consequence, there is a rising tendency to correct spinal deformity, even the most severe ones, by means of a single posterior technique avoiding the morbidity associated with anterior approach.
The aim of this study is to evaluate posterior only correction of adolescent idiopathic scoliosis as regards safety, efficacy and limitations.
16 AIS patients were included in this prospective non randomised study, all of them underwent single stage posterior correction of their deformities.
Inclusion criteria were; AIS >50 degrees, age between 10 to 30, and flexibility index ˂50%.
Every patient in this study was subjected to thorough preoperative clinical and radiological assessment, and followed for one year after correction that was done via posterior approach by radical posterior release, pedicle screw instrumentation and, in most of cases, neuromonitorization.
The mean age of our patients was 13.63ys, mean preoperative Cobb was 96.75 and flexibility index was 16%.
69% correction was obtained to a mean postoperative Cobb 29.75 degrees with 1% loss of correction over 1 year follow up.
Concerning complications, one patient developed permanent paraplegia (neurological complications 6.3%), one patient had superficial infection (infection 6.3%), 4 patients had cosmetic complications (3 shoulder imbalance, 1 coronal imbalance with proximal junctional kyphosis) (cosmetic complications 25.0%), and one patient had temporary respiratory support (respiratory complications 6.3%).
The results of this study were gathered together and compared to matched literature.
We concluded that posterior only correction for rigid scoliotic curves should not be considered a safe procedure without the availability of a good neuromonitoring team, although, the posterior approach has proved efficacy in treating most of rigid and large curves. Also, we were able to correct, safely, curves up to 125 degree by that single approach without major complications, so, we have no limitations for posterior correction of curves ≤ 125 degree, but we were not able to correct safely higher degree curves by this approach.