Lever Maneuver for Treatment of Large and Rigid Scoliosis

Current methods used to correct scoliosis must balance the rigidity of the deformity and the forces created by corrective measures. For large and rigid scoliosis, the rigidity of the deformity is difficult to overcome and satisfactory correction is elusive. Anterior release procedures are usually necessary to make the curves more flexible. The lever maneuver provides powerful corrective forces to overcome the rigidity of the deformity and obviates the need for anterior release procedures. The purpose of this study is to assess the efficacy and clinical value of the lever maneuver as a technique for correcting large (≥70°) and rigid (flexibility ≤30%) scoliosis. The study population consisted of 41 consecutive patients undergoing lever maneuver for the management of large and rigid scoliosis (congenital, idiopathic, or neuromuscular). Outcomes were evaluated using radiographic studies, monitoring of complications, and patient satisfaction as measured by the modified Scoliosis Research Society Instrument. The mean Cobb angle of the major curve was 98° (range, 75°-133°). The deformity correction was 67.1% (range, 51%-74%). Coronal imbalance was 2.5cm before and 0.8cm after surgery. No major complications occurred. Satisfactory correction was achieved without anterior release in all but one patient. All patients were very satisfied with their outcome regardless of the etiology of their deformity. The lever maneuver is an effective procedure for the management of large and rigid scoliosis and offers the advantages of reduced need for anterior release, fewer complications, and high patient satisfaction.

並列關鍵字

anterior release procedures ； large and rigid scoliosis ； lever maneuver

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