Cause analysis of and surgical strategy for revision surgery for adolescent idiopathic scoliosis

English Keywords:Adolescent idiopathic scoliosis  Reoperation  Complication

English Abstract:

  【Abstract】 Objective：To investigate the common causes and surgical strategy for revision surgery for adolescent idiopathic scoliosis.Method：10 patients underwent revision surgery due to failed primary spinal fusion surgery in our hospital from January　2003 to December 2008.Their detailed image data collected pre- and postoperatively，during the follow-up and the revision surgery，as well as the surgical strategies for both primary and revision surgery were collected and reviewed retrospectively.Result：Of 10 revision surgeries，fusion segments were extended due to progressive scoliosis in 5 surgeris；1 patient underwent proximal fusion extension due to proximal junctional kyphosis；3 patients had debridement and antibiotic therapy due to infection and instrument were maintained in 2 cases；1 patient underwent implant replacement and autograft due to pseudarthrosis and instrument failure.All 10 patients were followed up for 12～33 months（average，21.5 months）.At final follow-up，no malalignment，no scoliosis progression and disimbursement and instrument failure were　noted.Conclusion：The most common causes for revision surgery for adolescent idiopathic scoliosis are curve progression，infection，pseudarthrosis and abnormal proximal junctional kyphosis.Proper revision strategy can ensure satisfactory results.