Vertebral body stapling as an alternative in the treatment of idiopathic scoliosis

Objective. Unilateral vertebral body stapling as a fusionless alternative to control curvature progression in patients with idiopathic scoliosis (IS). Indications. Skeletally immature patients (Risser 0 or 1) with IS measuring 20-45 degrees and correction of the curvature <20 degrees on side-bending X-rays. Contraindications. Congenital scoliosis, curvature above T4 or below L4, thoracic kyphosis >40 degrees. Surgical technique. Unilateral disc-sparing staples are placed at the convex side. A thoracoscopic approach can be used for thoracic curves and a mini-open retroperitoneal approach for lumbar curves. Postoperative management. Early ambulation on postoperative day 1 is encouraged. There are no absolute activity restrictions, and no bracing beyond 4 weeks is required. Results. A total of 28 patients (4 males, 24 females; average age at operation 9.4 years) met all inclusion criteria and had a minimum 2-year follow-up (range 2-5.3 years). The success rate (improvement or stabilization of the curvature) was 86% for thoracic curves <35 degrees and all lumbar curves meeting the indications.