Transforming Scoliosis Care with Motion-Preserving Spine Surgery
Clinical Evidence: Adolescent Idiopathic Scoliosis (AIS) • India (Clinical Series)
Medical disclaimer: Individual results vary and depend on diagnosis, anatomy, and overall health. Case studies and outcomes shown here are illustrative examples and are not a guarantee of similar results for every patient.
Clinical Challenge & Background
Adolescent Idiopathic Scoliosis (AIS) affects approximately 1 in 300 growing children, leading to spinal deformity, back pain, and restrictive lung function if untreated. Traditionally, spinal fusion has been the gold standard, but it results in permanent loss of spine mobility, adjacent segment degeneration, and potential chronic pain in adulthood. For active teenagers, a major surgical challenge is correcting the scoliosis deformity while preserving natural spine motion.
Surgical Approach & Technique
Dr. Sajan K. Hegde implemented Nonfusion Anterior Scoliosis Correction (NFASC), also known as Anterior Vertebral Body Tethering (AVBT). Operating through a minimally invasive thoracoscopic approach, a flexible polymer tether is secured to the convex side of the curve using bone screws. Tensioning the tether restricts growth on the convex side while allowing the concave side to grow naturally (Hueter-Volkmann principle), leading to progressive correction. This is coupled with an Enhanced Recovery Pathway (ERP) for rapid mobilization.
Key Outcomes & Study Findings
Significant Curve Correction
Thoracic curves corrected from ~52° to ~17° and lumbar curves from ~51° to ~14° (68–73% improvement).
Preservation of Spinal Motion
Maintains natural spinal flexibility and spinal bending, avoiding the rigid, stiff back associated with traditional spinal fusion.
Improved Quality of Life
SRS-22r scores increased from 78 to 92.5, showing substantial improvement in pain, self-image, and mental health.
Rapid Enhanced Recovery
ERP protocol enabled mobilization within hours, reduced hospital stays, and minimized post-operative pain medication dependency.
Zero Major Complications
No major intraoperative or postoperative complications, and no patient required revision surgery during the follow-up period.
Recovery Timeline & Long-Term Results
In a cohort study of 75 adolescents followed for 2 to 5 years, NFASC demonstrated outstanding results. The main thoracic curve corrected from an average of ~52° down to ~17° (a 68-73% correction) while maintaining spinal flexibility. The SRS-22r quality of life scores improved significantly from 78 to 92.5, indicating less pain, better physical function, and improved self-image. ERP protocols enabled walking on day 1 and discharge by day 4, with zero major complications or revisions.
Real Patient Growth Modulation
Demonstrates progressive curve correction over time as the patient grows, leveraging growth modulation rather than a static fusion.