A novel approach to surgical treatment of adolescent idiopathic scoliosis in skeletally immature patients

Purpose: Describe the surgical technique and experience using the LSZ growing system in skeletally immature patients for two-stage surgical treatment of adolescent idiopathic scoliosis (AIS).

Methods: Eleven skeletally immature patients who underwent two-stage surgical treatment of AIS in our center were retrospectively analyzed. Patients initially treated with the LSZ growing system were observed for an average of 40.5 months (range 23-64 months) and for 4 years after planned replacement of the LSZ growing system with a standard pedicle screw system.

Results: The average preoperative angle of the main thoracic curve was 64.55 ± 3.21°, and that of the lumbar curve was 46 ± 5.52°. After instrumentation using the LSZ growing system, the thoracic curve was corrected to 17.63 ± 5.14°, and the lumbar curve to 9.2 ± 5.45°. The correction percentages were 72.52 ± 8.35 and 80.59 ± 10.77, respectively. After planned replacement of the LSZ system with a pedicle screw system, the angle of the thoracic curve changed to 11.45 ± 4.84°, and the lumbar curve to 6.4 ± 4.72°. The percentages of final correction were 82,1 ± 7,91 and 85,64 ± 5,47, respectively. The difference in the "LSZ growth coefficient" was 0.063 ± 0.037, which indicates continued growth of the spine along the instrumented region. None of the patients had neurological or infectious complications.

Conclusion: Our study demonstrates the safety and effectiveness of 2-stage treatment of AIS using the LSZ system, which allows for spine growth during the period between stages.