Thoracic Microdiscectomy and Arthrolysis of Costotransverse Joint as a Means of Releasing Technique for Idiopathic Scoliosis

The purpose of this study is to evaluate the effects of thoracic microdiscectomy(anterior release) and arthrolysis of costotransverse joint(partial resection of transverse process) as additional technique in posterior procedure for scoliosis. Subjects consisted of 11 idiopathic scoliosis patients (1 male and 10 females) aged 12 to 17 years(average:15.3), operated posteriorly using CD technique. The subjects were divided into 3 groups ; group A: three patients operated without release, group B: four patients with arthrolysis of costotransverse joint, group C ; four patients with microdiscectomy of three discs around the apical vertebra and arthrolysis of costotransverse joint, the average preoperative Cobb angle were, respectively, 56, 52 and 55 degrees. Cobb angle and disc wedge angle were measured. The correction rates of Cobb angle in the group A,B and C were 77%, 65%, and 53%, respectively. Improvement in the disc wedge angle was obtained especially in-group A. Microdiscectomy appeared to be effective to de-stabilize the thoracic curve. This additional technique provide excellent correction in one stage posterior procedure. Concerning to the arthrolysis of the costotransverse joint,more detailed study and biomechanical examination are needed for accurate evaluation.