The purpose of the present paper is to assess if Ponte osteotomies (POs) allow for a better correction in adolescent idiopathic scoliosis (AIS) surgery and to investigate their safety profile. A systematic search of electronic databases was conducted. Inclusion criteria: comparative studies that reported the outcomes of AIS patients who underwent surgical correction through posterior-only approach with and without POs. Clinical and radiographic outcomes were extracted and summarized. Meta-analyses were performed to estimate the differences between patients treated with and without POs. p < 0.05 was considered significant. In total, 9 studies were included. No significant difference in thoracic kyphosis (TK) change between patients treated with and without POs was found (+3.8 degrees; p = 0.06). Considering only hypokyphotic patients, a significant difference in TK change resulted in POs patients (+6.6 degrees; p < 0.01), while a non-significant TK change resulted in normokyphotic patients (+0.2 degrees; p = 0.96). No significant difference in coronal correction (2.5 degrees; p = 0.10) was recorded. Significant estimated blood loss (EBL) (142.5 mL; p = 0.04) and surgical time (21.5 min; p = 0.04) differences were found with POs. Regarding complications rate, the meta-analysis showed a non-significant log odds ratio of 1.1 (p = 0.08) with POs. In conclusion, POs allow for the restoration of TK in hypokyphotic AIS, without a significantly greater TK change in normokyphotic patients, nor a significantly better coronal correction. Considering the significantly greater EBL and the trend toward a higher complications rate, the correct indication for POs is crucial.

Faldini, C., Viroli, G., Traversari, M., Manzetti, M., Ialuna, M., Sartini, F., et al. (2024). Ponte Osteotomies in the Surgical Treatment of Adolescent Idiopathic Scoliosis: A Systematic Review of the Literature and Meta-Analysis of Comparative Studies. CHILDREN, 11(1), 1-19 [10.3390/children11010092].

Ponte Osteotomies in the Surgical Treatment of Adolescent Idiopathic Scoliosis: A Systematic Review of the Literature and Meta-Analysis of Comparative Studies

Faldini, Cesare;Viroli, Giovanni;Traversari, Matteo;Manzetti, Marco;Ialuna, Marco;Sartini, Francesco;Cargeli, Alessandro;Parisi, Stefania Claudia;Ruffilli, Alberto
2024

Abstract

The purpose of the present paper is to assess if Ponte osteotomies (POs) allow for a better correction in adolescent idiopathic scoliosis (AIS) surgery and to investigate their safety profile. A systematic search of electronic databases was conducted. Inclusion criteria: comparative studies that reported the outcomes of AIS patients who underwent surgical correction through posterior-only approach with and without POs. Clinical and radiographic outcomes were extracted and summarized. Meta-analyses were performed to estimate the differences between patients treated with and without POs. p < 0.05 was considered significant. In total, 9 studies were included. No significant difference in thoracic kyphosis (TK) change between patients treated with and without POs was found (+3.8 degrees; p = 0.06). Considering only hypokyphotic patients, a significant difference in TK change resulted in POs patients (+6.6 degrees; p < 0.01), while a non-significant TK change resulted in normokyphotic patients (+0.2 degrees; p = 0.96). No significant difference in coronal correction (2.5 degrees; p = 0.10) was recorded. Significant estimated blood loss (EBL) (142.5 mL; p = 0.04) and surgical time (21.5 min; p = 0.04) differences were found with POs. Regarding complications rate, the meta-analysis showed a non-significant log odds ratio of 1.1 (p = 0.08) with POs. In conclusion, POs allow for the restoration of TK in hypokyphotic AIS, without a significantly greater TK change in normokyphotic patients, nor a significantly better coronal correction. Considering the significantly greater EBL and the trend toward a higher complications rate, the correct indication for POs is crucial.
2024
Faldini, C., Viroli, G., Traversari, M., Manzetti, M., Ialuna, M., Sartini, F., et al. (2024). Ponte Osteotomies in the Surgical Treatment of Adolescent Idiopathic Scoliosis: A Systematic Review of the Literature and Meta-Analysis of Comparative Studies. CHILDREN, 11(1), 1-19 [10.3390/children11010092].
Faldini, Cesare; Viroli, Giovanni; Traversari, Matteo; Manzetti, Marco; Ialuna, Marco; Sartini, Francesco; Cargeli, Alessandro; Parisi, Stefania Claud...espandi
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/958473
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