Annulotomy and Nuclectomy in Early Onset Scoliosis

·(c – DePuy AcroMed, a – Johnson & Johnson Company)

Annulotomy facilitates anterior release when combined with posterior instrumentation without fusion techniques. Adequate release may be difficult, due to limited access to the concavity. Our technique of apical annulotomy and nuclectomy, with growth plate preservation, allows division of the concave annulus from within the disc space after nuclectomy. The surgical technique is presented. The results are illustrated with six prospectively reviewed cases of thoracic release and posterior paediatric Isola instrumentation. Each patient has undergone lengthening (1- 4) with an average of 1 cms distraction achieved. A mean of 40.9% curve correction was achieved at 18 months average follow up. No evidence of anterior fusion is demonstrated radiologically or clinically, as shown by the surgical ability to achieve subsequent distraction.

· If noted, the author indicates something of value received. The codes are identified as: a-research or institutional support; b-miscellaneous funding; c-royalties; d-stock options.