Analysis of correlation between regional implant density and the correction rate in treatment of Lenke 1A and 1B adolescent idiopathic scoliosis with pedicle screws

ABSTRACT Objective: The objective was to investigate implant density or the number of screws correlated with the correction of the main curve in patients undergoing surgery for adolescent idiopathic scoliosis (AIS). Methods: We evaluated 112 medical records: 33 patients with screw density of up to 50%, and 79 patients with a density of 100%; all patients underwent surgical correction by posterior approach with transpedicular fixation. Results: In the group of patients with screw density of up to 50% the residual Cobb median was 10°; in the group with 100% density, the median was 7°. Conclusion: Biostatistical analysis showed that the group with up to 50% of screw density presented correction rate of 82.1% and the group with 100% density had correction of about 86.8%. It is therefore concluded that the difference is statistically significant in favor of the fixation with 100% density (p =0.010).

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Radiological outcomes of the selective spinal fusion for lenke type 5C adolescent idiopathic scoliosis

MOJ Orthopedics & Rheumatology ◽

10.15406/mojor.2021.13.00538 ◽

2021 ◽

Vol 13 (1) ◽

pp. 6-9

Author(s):

Ghanshyam Kakadiya ◽

Kalpesh Saindane ◽

Viraj Gandbhir ◽

Yogesh Soni, ◽

Kushal Gohil ◽

...

Keyword(s):

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Cobb Angle ◽

Spinal Instrumentation ◽

Pedicle Screws ◽

P Value ◽

Coronal Balance ◽

Angle Correction ◽

The Mean ◽

Implant Density

Objective: To determine the short term radiological outcomes of Lenke type 5C adolescent idiopathic scoliosis in terms of Cobb angle correction and coronal balance after selective posterior segmental spinal instrumentation with pedicle screws. Methods: This retrospective cohort study was conducted in the department of Orthopaedic at tertiary care public hospital of Mumbai, India. The medical records of patients from 17th April 2015 to 29th October 2019 who underwent a selective spinal fusion with pedicle screws for Lenke type-5C adolescent idiopathic scoliosis were reviewed. Preoperative radiographs were evaluated for Cobb angle of the lumbar or thoracolumbar curve as well as a sagittal and lumbar modifier on anteroposterior and lateral standing films. The curve correction, implant density, number of segment fused and coronal balance was assessed on postoperative radiographs. The pre and postoperative comparison of important study variables was done and P-value was calculated with the help of the chi-square test. P-value <0.05 was considered statistically significant. Results: The total number of patients was 34. Majority (94.1%, n=32) were females while only 2(5.9%) were males. The mean age at the time of operation was 14.35±2.19 years (range 8 to 19 years). Mean pre-operative and post-operative Cobb angles were 61.790±13.120 (range 400 to 850) and 10.550±8.710 (range 00 to 300) respectively (P-value 0.00). The mean percentage of curve correction and percentage of fulcrum flexibility was 83.35±13.07 % (range 55% to 100%) and 59.56%±15.07 (range 28.57% to 84.60%) respectively (P value 0.469). Mean implant density and fusion mass was 66.03±7.94% (range 53 to 79%) and 10.32±2.8 (range 7 to 15%) segments respectively. The coronal balance was achieved in all patients. No major complication was noted. Conclusion: Near normal Cobb angle correction and coronal balance was achieved in all patients of Lenke type 5C adolescent idiopathic scoliosis treated with posterior segmental spinal instrumentation utilizing pedicle screws.

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Biomechanical Comparison of the Load-Sharing Capacity of High and Low Implant Density Constructs With Three Types of Pedicle Screws for the Instrumentation of Adolescent Idiopathic Scoliosis

Spine Deformity ◽

10.1016/j.jspd.2018.06.007 ◽

2019 ◽

Vol 7 (1) ◽

pp. 2-10 ◽

Cited By ~ 3

Author(s):

Julien Clin ◽

Franck Le Navéaux ◽

Mark Driscoll ◽

Jean-Marc Mac-Thiong ◽

Hubert Labelle ◽

...

Keyword(s):

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Pedicle Screws ◽

Load Sharing ◽

Implant Density ◽

Biomechanical Comparison

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Correction of adolescent idiopathic scoliosis using a convex pedicle screw technique with low implant density

The Bone & Joint Journal ◽

10.1302/0301-620x.103b3.bjj-2020-0760.r1 ◽

2021 ◽

Vol 103-B (3) ◽

pp. 536-541

Author(s):

Peter W. Ferlic ◽

Laurenz Hauser ◽

Michael Götzen ◽

Richard Andreas Lindtner ◽

Stefan Fischler ◽

...

Keyword(s):

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Cobb Angle ◽

Pedicle Screw ◽

Operating Time ◽

Pedicle Screws ◽

Patient Reported ◽

Group 2 ◽

Implant Density ◽

Group 1

Aims The aim of this retrospective study was to compare the correction achieved using a convex pedicle screw technique and a low implant density achieved using periapical concave-sided screws and a high implant density. We hypothesized that there would be no difference in outcome between the two techniques. Methods We retrospectively analyzed a series of 51 patients with a thoracic adolescent idiopathic scoliosis. There were 26 patients in the convex pedicle screw group who had screws implanted periapically (Group 2) and a control group of 25 patients with bilateral pedicle screws (Group 1). The patients’ charts were reviewed and pre- and postoperative radiographs evaluated. Postoperative patient-reported outcome measures (PROMs) were recorded. Results The number of implants (14.5 vs 17.1) and the implant density (1.5 vs 1.9) were significantly lower in Group 2 (p < 0.001). Operating time was 27 minutes shorter in Group 2 than in Group 1, with a mean of 217 minutes (SD 50.5; 120 to 346). The duration of surgery per instrumented vertebra was reduced by 19% in Group 2 (p = 0.011). No statistical difference was found in the postoperative Cobb angle, vertebral rotation, the relative correction achieved, or postoperative PROMs. Conclusion Despite a lower implant density and achieving correction through a convex rod, surgical correction of the Cobb angle and vertebral body rotation was similar in both groups. Periapical pedicle screws and primary correction on the concave side do not seem to be mandatory in order to achieve good surgical results in idiopathic thoracic scoliosis. The operating time was shorter in the group with lower implant density. In conclusion, the technique provided good results and has the potential to reduce complications and costs. Cite this article: Bone Joint J 2021;103-B(3):536–541.

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Comparison of Changes in SRS-22 Values with Improvement in Cobb Angles after Posterior Fusion Surgery in Adolescent Idiopathic Scoliosis

Zeitschrift für Orthopädie und Unfallchirurgie ◽

10.1055/a-1401-0477 ◽

2021 ◽

Author(s):

Kadir Gem ◽

Sertan Hancioglu ◽

Abdulkadir Bilgiç ◽

Serkan Erkan

Keyword(s):

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Cobb Angle ◽

Posterior Instrumentation ◽

Research Society ◽

Posterior Fusion ◽

Improvement Rate ◽

Scoliosis Research Society ◽

Correction Rate ◽

Group B

Abstract Introduction The purpose of this study was to evaluate the relationship between the correction rate in Cobb angle and the improvement in quality of life profile in terms of Scoliosis Research Society (SRS)-22 values. Patients and Methods Between January 2007 and December 2013, posterior instrumentation and fusion was performed to 30 patients with adolescent idiopathic scoliosis (AIS). Patients were grouped according to their improvement rate in Cobb angles after surgery. Patients with an improvement rate of > 80% were grouped as Group A; those with an improvement rate of > 60% and ≤ 80% as Group B and those with an improvement rate of ≤ 60% were grouped as Group C. The SRS-22 questionnaire of these three groups was calculated and their relationship with the improvement in Cobb angle was evaluated. Results No statistical difference was found among the three groups in terms of pain, appearance, function, spirit, satisfaction, and SRS-22 values (all p > 0.05). Conclusion The results of this study demonstrate that the degree of correction rate does not correlate with the degree of improvement in the SRS-22 questionnaire in patients with AIS that underwent posterior fusion and instrumentation.

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Initial Correction Rate Can be Predictive of the Outcome of Brace Treatment in Patients With Adolescent Idiopathic Scoliosis

Clinical Spine Surgery ◽

10.1097/bsd.0000000000000343 ◽

2017 ◽

Vol 30 (4) ◽

pp. E475-E479 ◽

Cited By ~ 9

Author(s):

Leilei Xu ◽

Xiaodong Qin ◽

Yong Qiu ◽

Zezhang Zhu

Keyword(s):

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Brace Treatment ◽

Correction Rate ◽

Initial Correction

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Does Implant Density Impact Three-Dimensional Deformity Correction in Adolescent Idiopathic Scoliosis with Lenke 1 and 2 Curves Treated by Posterior Spinal Fusion without Ponte Osteotomies?

Asian Spine Journal ◽

10.31616/asj.2020.0398 ◽

2021 ◽

Author(s):

Thamrong Lertudomphonwanit ◽

Chirag A. Berry ◽

Viral V. Jain ◽

Peter F Sturm

Keyword(s):

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Spinal Fusion ◽

Three Dimensional ◽

Deformity Correction ◽

Posterior Spinal Fusion ◽

Implant Density

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Uniplanar cannulated pedicle screws in the correction of Lenke type 1 adolescent idiopathic scoliosis (AIS)

10.21203/rs.3.rs-34233/v1 ◽

2020 ◽

Author(s):

Yiwei Zhao ◽

Wubo Liu ◽

Suomao Yuan ◽

Yonghao Tian ◽

Xinyu Liu

Keyword(s):

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Pedicle Screws ◽

Vertebral Rotation ◽

Concave Side ◽

Convex Side ◽

X Rays ◽

Group A ◽

Group B

Abstract Background In the present study, we reported the clinical use of uniplanar cannulated pedicle screws for the correction of Lenke type 1 adolescent Idiopathic scoliosis (AIS), and its safety and clinical outcomes were also evaluated. Methods 68 patients with Lenke type 1 AIS were included, among which 38 patients were treated with uniplanar cannulated screws at the concave side of periapical levels and multiaxial screws at the other levels (group A). Moreover, the remaining 30 patients were treated with all multiaxial screws (group B). The preoperative and postoperative radiographic parameters of the Lenke type 1 AIS, axial vertebral rotation, and the safety of the pedicle screws were evaluated by X-rays and computed tomography (CT). Results Preoperative data was comparable between two groups. The postoperative proximal thoracic (PT) curve, main thoracic (MT) curve, thoracolumbar/lumbar (TL/L) curve, and apical vertebral rotation were significantly improved compared with the preoperative data. The coronal correction rates in group A and B were 83% and 81.9%, respectively (P > 0.05). The derotation rates in group A and B were 60.8% and 43.2%, respectively (P < 0.05). The rotation classification in the group A was also better compared with the group B. The misplacement rate in group A and B was 7.9% and 11.8%, respectively (P < 0.05), and the total misplacement rate on the concave side (11.4%) was higher than that of convex side (8.4%). The lateral perforation was found at the concave side, while the medial perforation was found at the convex side. On the concave side, the misplacement rate in group A and B was 9.7% and 12.3%, respectively (P < 0.05). The grades 2 and 3 perforations were three (3.5%) in the group A and eight (8.2%) in the group B (P < 0.05). On the convex side, the misplacement rate in group A and B was 5.9% and 11.1%, respectively (P < 0.05). The grades 2 and 3 perforations were one (0.9%) in the group A and four (4.4%) in the group B (P < 0.05). Conclusion Collectively, uniplanar cannulated pedicle screws could effectively increase the accuracy of pedicle screws and facilitate the derotation of the apical vertebra compared with the multiaxial pedicle screws. Trial registration retrospectively registered

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