Tratamiento quirúrgico de la escoliosis idiopática del adolescente

The operative management of scoliosis has gone through a very dynamic evolution over the past 50 years with especially rapid explosion of new techniques in the past 10 to 15 years. From the early 1900s to the late 1950 the standard surgical treatment was a posterior fusion supported by postoperative cast. Introduction of spinal instrumentation combined with spinal fusion was the major step forward in the operative management of scoliosis. The concept of segmental instrumentation was expanded to include multiple hook and rod instrumentation. Last years the multisegmental instrumentation and the use of pedicle screws were introduced to add correction and stability, and the patients were able to leave the hospital without wearing a cast or a brace. Advances in anesthesia and postoperative care have allowed surgeons to perform more complex surgery, including same day anterior and posterior procedures and the index of complications decrease dramatically.