Surgical Outcomes Research

Benefits of the Anterior Approach. Selected patients with adolescent idiopathic scoliosis who have thoracic curves classified as Lenke et al ¹² Type 1 (main thoracic) or Type 3 (double major curve) may benefit from anterior instrumentation, as compared with posterior instrumentation. The following criteria must be met: history consistent with idiopathic scoliosis and physical examination showing minimal lumbar prominence that reduces almost completely in the prone position. Indications include: radiographic analysis showing the ability to save two or more distal fusion levels, as predicted by the lower instrumented vertebra with posterior instrumentation (end of Cobb vertebra); presence of hypokyphosis, with a desire to correct the sagittal plane; or skeletal maturity that necessitates anterior discectomy.