scholarly journals Posterior Correction of Adolescent Idiopathic Scoliosis with High-Density Pedicle Screw-Only Constructs: 5 Years of Follow-Up

2020 ◽  
Vol 61 (4) ◽  
pp. 323
Author(s):  
Chang Ju Hwang ◽  
Jong-Min Baik ◽  
Jae Hwan Cho ◽  
So Jeong Yoon ◽  
Dong-Ho Lee ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Pedicle Screw ◽  
High Density ◽  
Posterior Correction

scholarly journals Comparative analysis of pedicle screw versus hybrid instrumentation in adolescent idiopathic scoliosis surgery

2016 ◽  
Vol 7 (04) ◽  
pp. 550-553 ◽  
Author(s):  
Sohail Rafi ◽  
Naseem Munshi ◽  
Asad Abbas ◽  
Rabia Hassan Shaikh ◽  
Imtiaz Hashmi
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Cobb Angle ◽  
Pedicle Screw ◽  
Pedicle Screws ◽  
Scoliosis Surgery ◽  
Hybrid Instrumentation ◽  
System Versus ◽  
Cobb’S Angle

ABSTRACT Introduction: Adolescent idiopathic scoliosis is the most common type of scoliosis. A Cobb angle of 50° will progress beyond the age of spinal maturity. Surgery over bracing is advised at a Cobb angle above or equal to 50°. The aim of surgery is to bring the Cobb angle down below 50° to prevent reprogression as well as improve the quality of life. The objective of the study is to analyze the efficacy and significance in lifestyle improvement of pedicle screw-only fixation system versus the more common hybrid instrumentation system used for the surgical treatment of adolescent idiopathic scoliosis. Materials and Methods: A prospective cohort study was conducted involving two groups of patients were included in the study. One group was operated with pedicle screw-only method while the other with hybrid instrumentation system. The pre- and post-operative Cobb’s angles were taken across a follow-up of 4 years. An SRS-30 questionnaire was given in a yearly follow-up to assess the lifestyle improvement of the patient. Results: Pedicle screw-only method was significantly more effective in reducing Cobb’s angle (P = 0.0487). It was showed less loss of correction (P = 0.009) pedicle screw-only surgery was also better at reducing thoracic curves (P = 0.001). There seemed a better recovery time with pedicle screw surgery (P = 0.003). Conclusion: Pedicle screws are more effective and durable than hybrid systems at when treating adolescent idiopathic scoliosis.

Comparison of 5-year outcomes between pedicle screw and hybrid constructs in adolescent idiopathic scoliosis

2012 ◽  
Vol 17 (3) ◽  
pp. 212-219 ◽  
Author(s):  
Steven W. Hwang ◽  
Amer F. Samdani ◽  
Ben Wormser ◽  
Hari Amin ◽  
Jeff S. Kimball ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Thoracic Curve ◽  
Patients Âgés ◽  
Thoracic Curvature ◽  
Main Thoracic

Object Pedicle screw fixation has been theorized to provide better correction of scoliotic deformity, but controversy over the benefits of pedicle screw–only constructs remains, and the longer-term impact of pedicle screw fixation as compared with hybrid constructs is unclear. In this study, a retrospective review of a prospectively collected database was conducted to determine the longer-term impact of pedicle screw fixation as compared with hybrid constructs in patients with adolescent idiopathic scoliosis (AIS). Methods The authors retrospectively reviewed a multicenter database of pediatric patients (ages ≤ 18) from 1995 to 2006 and identified 127 patients with Lenke Type 1–4 AIS curves with a minimum 5 years of follow-up. Patients were divided into 2 cohorts based on whether they had undergone pedicle screw fixation or fixation with hybrid constructs. Results The mean main thoracic curvature of 56.1° ± 13.0°, which corrected to 14.9° ± 9.3°, translated into a mean correction of 73% (p < 0.01). The curve was 19.4° ± 10.6° at 2-year follow-up and 20.5° ± 10.4° at 5 years. When comparing preoperative parameters between the groups, differences were noted in the magnitude of the main thoracic curve (p = 0.04), flexibility of the main thoracic curve (p = 0.02), coronal balance (p = 0.04), T2–12 kyphosis (p = 0.02), and sex (p = 0.02). The pedicle screw cohort had fewer spinal segments instrumented (p < 0.01), fewer anterior releases performed (p = 0.02), and fewer thoracoplasties performed (p < 0.01). By 5 years of follow-up, significant differences were apparent between the two cohorts with respect to upper thoracic curvature (p = 0.01), T2–12 (p = 0.02) and T5–12 (p = 0.02) kyphosis, lumbar lordosis (p < 0.01), and sagittal balance (p = 0.01). Conclusions Although some preoperative differences did exist, outcomes were comparable between hybrid and screw constructs at 2 and 5 years. However, hybrid constructs required more concurrent anterior releases and thoracoplasties to achieve similar results.

scholarly journals Posterior Spinal Fusion Extended to Stable Vertebra Provides Similar Outcome in Juvenile Idiopathic Scoliosis Patients Compared with Adolescents with Fusion to the Touched Vertebra

2018 ◽  
Vol 108 (1) ◽  
pp. 83-89 ◽  
Author(s):  
H. Oksanen ◽  
M. Lastikka ◽  
L. Helenius ◽  
O. Pajulo ◽  
I. Helenius
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Spinal Fusion ◽  
Pedicle Screw ◽  
Posterior Spinal Fusion ◽  
Research Society ◽  
Adolescent Group ◽  
Scoliosis Research Society ◽  
Juvenile Idiopathic Scoliosis

Background and Aims: To compare outcomes between posterior spinal fusion of juvenile idiopathic scoliosis and adolescent idiopathic scoliosis patients with a minimum of 2-year follow-up. The juvenile idiopathic scoliosis patients were fused to the stable vertebra and adolescent idiopathic scoliosis to the touched vertebra. We hypothesized that extending the spinal fusion to the stable vertebra in juvenile patients would provide similar outcomes compared with fusion to the touched vertebra in adolescents. Materials and Methods: A prospective comparative study of 21 consecutive children with juvenile (Risser 0) and 84 adolescent (Risser ⩾2) idiopathic scoliosis (1:4 ratio) undergoing bilateral segmental pedicle screw instrumentation and direct vertebral derotation with a minimum of 2-year follow-up. Results: Juvenile patients had a significantly larger main curve (58° vs 53°, p = 0.003), more fused levels (p = 0.012) and posterior column osteotomies (p = 0.014) than adolescent patients. Distal adding-on (>10°) was observed in one (4.7%) juvenile and three (3.6%) adolescent patients (p = 0.80), without the need for revisions. Scoliosis Research Society 24 total score averaged 101 in juvenile and 97 in adolescent group at 2-year follow-up (p = 0.047). Conclusion: Posterior spinal fusion with bilateral segmental pedicle screw instrumentation to the stable vertebra provides similar clinical and radiographic outcomes in juvenile patients as compared with adolescents with fusion to the touched vertebra in idiopathic scoliosis. Health-related quality of life as measured using the Scoliosis Research Society 24 questionnaire at the end of follow-up was better in the juvenile as compared with the adolescent group.

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