Are inferior facetectomies adequate and suitable for surgical treatment of adolescent idiopathic scoliosis?

Study Design: Retrospective review. Background: Inferior facetectomies, with the utilization of segmental pedicle screw constructs for corrective fixation, can provide adequate flexibility and post less risk of neural tissue and blood loss. We analyzed outcomes of surgical treatment for adolescent idiopathic scoliosis (AIS) using inferior facetectomies and segmental pedicle screw constructs. We hypothesized that adequate main curve correction and suitable surgical outcomes would be observed using this technique. Methods: We reviewed 38 AIS patients who underwent inferior facetectomies and segmental pedicle screw constructs by 2 surgeons at a single institution between May 2014 and December 2016. Coronal and sagittal radiographic measurements were evaluated over 1-year follow-up by 2 trained observers not associated with the surgeries. Surgical details, complications, and hospital length of stay (LOS) were also recorded. Results: Mean fusion levels were 11.0 +/- 1.7. The mean Cobb angle of main AIS curves improved from 48.6 +/- 10.1 degree preoperatively to 11.8 +/- 6.2 degree postoperatively and 12.4 +/- 6.2 degree at 1-year follow-up, which percentage correction was 75.9% and 74.6%, respectively. The mean thoracic kyphosis (T5-12) angle was 20.7 +/- 11.6 degree preoperatively, 17.4 +/- 8.0 degree postoperatively, and 16.8 +/- 8.4 degree at 1-year follow-up. The mean surgical time, estimated blood loss, and LOS were 232.4 +/- 35.7 minutes, 475.0 +/- 169.6 mL, and 3.5 +/- 1.3 days. Twelve patients received blood transfusion. There were no neurological or wound complications. Conclusions: This case series demonstrated adequate correction of main AIS curves, acceptable thoracic kyphosis and blood loss, and short surgical time and LOS in AIS patients treated with inferior facetectomies and segmental pedicle screw constructs, potentially indicating that inferior facetectomies are adequate and suitable for AIS surgery when segmental pedicle screw constructs are utilized.