To evaluate the results of a posterior procedure with segmental pedicle screw fixation in severe adolescent idiopathic scoliosis ≥70 °.

Twenty-three adolescent idiopathic patients with a curve magnitude ≥70 ° subject to segmental pedicle screw fixation were analyzed retrospectively with a minimum follow-up of 2 years (2-7.8 years). There were 19 females and 4 males with a mean age of 14.9 years. All patients, except for 4 patients with King type I, were subjected to thoracic curve fusion. Twenty patients showed a thoracic curve ≥70 ° (70-96), and 4 patients had a lumbar curve ≥70 ° (70-77), preoperatively. The preoperative and postoperative standing roentgenograms were used to check the radiological parameters.

The mean preoperative thoracic curve was corrected from 79.5±9.1 ° to 25.3±5.8 ° at the most recent follow-up, showing a correction of 67.9±7.8% and loss of correction of 2.5±1.9%. The mean preoperative lumbar curve was corrected from 72.3±3.3 ° to 30.0±10.1 ° at the most recent follow-up (58.4±14.8% curve correction, 2.4±2.5% loss of curve correction). The mean preoperative lowest instrumented vertebral tilting was corrected from 30.0±7.4 ° to 10.5±5.6 °, showing a correction of 64.8±20.9%. The preoperative thoracic kyphosis improved from 28.3±11.2 ° (0-50 °) to 35.0±9.1 ° (22-53 °) postoperatively. There was neither pseudoarthrosis nor complications related to the pedicle screws at the most recent follow-up.

Segmental pedicle screw fixation without an anterior release procedure in severe adolescent idiopathic scoliosis produced a satisfactory deformity correction with no significant loss of the curve correction. This procedure obviates the need for the anterior release and reduces the complications associated with anterior surgery.