EP245
E-Poster
Hyperselective Segmental Fusion Deformity Correction Technique for Adolescent Idiopathic Scoliosis
Yudha Mathan Sakti, Tedjo Rukmoyo, Zikrina Abyanti Lanodiyu, Deas Makalingga Emiri, Kadek Egadia Calisto
Department of Orthopaedics and Traumatology, Dr Sardjito General Hospital, Yogyakarta, Indonesia
Adolescent Idiopathic Scoliosis (AIS) is a three-dimensional spinal deformity affecting 2 – 4% of adolescents aged 10 – 18 years. Surgical intervention is often required for curves exceeding 40° to restore spinal alignment, prevent complications, and improve quality of life. Current selective fusion technique stabilizes the spine but still limit the flexibility. Hyperselective segmental fusion deformity correction offers a novel approach by targeting only the primary structural curve, preserving motion segments while achieving optimal correction. This study aims to present practical approach for performing hyperselective segmental fusion deformity correction technique. Our inclusion criteria included patients diagnosed with adolescent idiopathic scoliosis (AIS) Lenke 5 who underwent hyperselective segmental fusion deformity correction. Our technique followed simplified, six-steps protocol focusing on key aspects to consider before performing the procedure : defining the scoliosis classification, clinical criteria requirement, radiological requirement, defining upper instrumented vertebra (UIV), defining lower instrumented vertebra (LIV), and follow up. Data on surgical outcomes, complication rates, and cost comparisons were collected and analyzed. Hyperselective segmental fusion focuses on fusing only the primary structural curve, allowing compensatory curves to realign naturally. In the conventional selective fusion, UIV is often at upper end vertebra (UEV) of the main curve. Our study demonstrated that a hyperselective fusion strategy, in which UIV is one level caudal to UEV, is a reasonable alternative in the treatment of AIS. Our 1st month post operative data from the patients have shown a significant correction result on structural lumbar curve cobb’s angle and good correction on compensatory main thoracic curve. Proper patient selection is critical, considering factors such as curve classification, curve flexibility, skeletal maturity, and sagittal alignment. Radiological outcomes in this case series demonstrated successful deformity correction without compromising sagittal balance or neurological function. Hyperselective segmental fusion is an effective surgical option for AIS, achieving significant deformity correction while preserving motion segments. This technique able to preserve motion following post-operative and maintain daily functionality. Making it a promising treatment for Adolescent Idiopathic Scoliosis
