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The Use of Multiple Anchors for the Treatment of Idiopathic Scoliosis

Study Design. Retrospective study. Objective. The purpose of this study was to determine the effectiveness of concave collar-button wires used as anchors to correct and maintain spinal alignment in adolescent idiopathic scoliosis (AIS). Summary of Background Data. Correction of idiopathic scoliotic deformity has been reported with various systems. We have added concave collar-button wires to a multihook, dual-rod system as an adjunct to translation and stabilization of the spine during correction of AIS. Methods. Sixty-seven patients failing brace treatment or with curve patterns >45° underwent spinal correction. Evaluation was obtained with preoperative standing posteroanterior, lateral, and recumbent right and left bending radiographs using the Cobb method. The initial postoperative films and latest radiographs were measured also. A dual-rod multihook construct with a derotation maneuver was used in all cases. Collar-button wire implants were placed from the convex side of the deformity toward the concave rod through the base of the spinous processes within the construct to achieve and augment correction and stability. Twenty-four patients underwent prior anterior release and fusion by video assisted thoracoscopic surgery. Results. Sixty-seven patients in total underwent this procedure. We achieved a 72.2% mean correction of thoracic curves and 63.2% mean correction of lumbar curves. There was a mean loss of correction of 2° in the thoracic area and 2.2° in the lumbar area after 2 years. Sagittal curve was unchanged after surgery. All patients demonstrated a solid fusion with no evidence of pseudarthrosis or junctional deformities. There were no cases of clinically significant wire breakage or hook pullout. Three delayed infections were noted. Conclusion. The use of multiple concave collar-button wires as anchors is a safe, easy, and reliable method of spinal stabilization in the coronal and sagittal planes. There is minimal loss of correction at long-term follow-up.