Impact of the Choice of the Distal Vertebral in the Surgery of the Thoracic Adolescent Idiopathic Scoliosis
Condition: Scoliosis
MeSH terms: Scoliosis
Study type: Interventional

Summary: 
      The problem of choosing the supporting vertebra was the subject of several studies. They do
      not suggest as regards the techniques that are not currently used or with insufficient
      setback.

      The need to have a sufficient number of files with a minimum decline of 5 years for proposing
      a multicenter study that will be conducted within the framework of the Scoliosis Research
      Group (SRG) and will result in a roundtable at the next congress GES in March 2015. the GES
      gathers most of the teams that support this pathology.
    

Detailed description: 
      Idiopathic scoliosis is a deformity in three planes of space the child's spine and scalable
      teenager with growth. In adults is causing severe deformities of respiratory failure
      responsible and disabling back pain. Scoliosis is most often idiopathic without cause found
      that the genetic origin is being identified. It is detected by the school doctor, the doctor
      or pediatrician. The management is based primarily on monitoring small angle discoveries
      scoliosis and the orthopedic treatment of progressive scoliosis by the specialized services
      of pediatric orthopedics or rehabilitation as recommended by the HAS (February 2008).
      Surgical treatment is reserved for the orthopedic treatment failures or advanced scoliosis
      discovered too late.

      The goal of surgery is to reduce as much as possible distortion in the three planes of space
      and avoid the progression of the deformity in adulthood. Its principle is to correct the
      deformity using instrumentation and maintain over time this correction with a bone graft.
      This is commonly called spinal fusion with instrumentation. The instrumentation includes all
      of the vertebral anchors connected to rods.

      Indications are asked in each case most often in adolescence and sometimes in younger
      children and rarely in adulthood. The procedure performed in adolescence allows to benefit
      from a flexible spine still allowing good reduction of the deformation, a lesser neurological
      risk and good consolidation of the bony fusion guarantees a stable income in the long term.

      Among all types of curves, thoracic scoliosis pose the problem of choosing the bends to be
      instrumented. This choice is an essential element for the initial correction and become the
      long-term. It is the result of a compromise between a long instrumentation that orchestrates
      all of the deformation to the detriment of the mobility of the lumbar spine and a shorter
      instrumentation that preserves mobility at the expense perhaps of a smaller reduction. These
      short instrumentations called selective thoracic instrumentation, the choice of the support
      or lower vertebra vertebra of instrumentation is an unsolved problem and is the subject of
      this work.

      The immediate results of the posterior vertebral arthrodesis are assessed by the correction
      of the deformity in three planes of space: measuring the angle of the curvature in the
      coronal plane, analyzing the return of a physiological kyphosis in sagittal plane and
      correction of the vertebral rotation in the horizontal plane. The results for medium and long
      term are assessed by analyzing the maintenance of correction of the deformity and the
      evolution of the above spine and above underlying arthrodesis. This is appreciated by the
      coronal and sagittal balance, changing the supporting vertebra and the first non-instrumented
      vertebra and evolution spine underlying uninstrumented.

      The problem of choosing the supporting vertebra was the subject of several studies. They do
      not suggest as regards the techniques that are not currently used or with insufficient
      setback.

      The need to have a sufficient number of files with a minimum decline of 5 years for proposing
      a multicenter study that will be conducted within the framework of the Scoliosis Research
      Group (SRG) and will result in a roundtable at the next congress GES in March 2015. the GES
      gathers most of the teams that support this pathology.
    

Intervention name(s): Scoliosis
Intervention type(s): Other
Intervention description(s): self-administered questionnaire (SRS 30) to assess the state of health and disability of patients.
Collection of patient's radiographic and clinical parameters
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Other
Keywords: scoliosis