• Yangpu Zhang, Yong Hai, Luming Tao, Jincai Yang, Lijin Zhou, Peng Yin, Aixing Pan, Yaoshen Zhang, and Chang Liu.
• Department of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Chaoyang District, Beijing, China.
• World Neurosurg. 2019 Jul 1; 127: e467-e473.

ObjectiveTo evaluate the efficacy and safety of posterior multiple-level asymmetrical Ponte osteotomies for rigid adult idiopathic scoliosis.MethodsA retrospective study was conducted for adult patients with rigid idiopathic scoliosis (flexibility of main curve <25%) who underwent one-stage multiple-level asymmetrical Ponte osteotomies with a minimum of 2-year follow-up between February 2009 and November 2015. The demographic data and surgical issues were collected, and the improvement of clinical function scores and radiologic parameters were obtained after surgery and during the follow-up to assess deformity correction, spinal balance, and clinical outcome.ResultsA total of 49 patients were included (10 male and 39 female) in this study, with an average age of 26.53 years old. The average follow-up was 28.37 ± 6.98 months. All the cases presented a significant improvement of the main curve and focal kyphosis from 85.62 ± 19.80° to 36.19 ± 16.74° and 53.98 ± 26.80° to 30.88 ± 18.69°, with a mean correction rate of 57.73% and 41.23%. The postoperative coronal and sagittal parameters were all significantly improved, except coronal balance. The mean operative time and blood loss were 267.86 ± 54.49 minutes and 838.78 ± 538.93 mL. All the clinical function scores of patients were significantly improved at the final follow-up. Only one patient had a complication related to surgical incision, with no neurologic complications occurring.ConclusionsThe surgical procedure of multiple-level asymmetrical Ponte osteotomy is a safe and effective technique, with reduced operation time, blood loss, and complications, and may offer an appropriate option to address the problems of rigid adult idiopathic scoliosis.Copyright © 2019 Elsevier Inc. All rights reserved.

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