Posterior Correction of Adolescent Idiopathic Scoliosis with High-Density Pedicle Screw-Only Constructs: 5 Years of Follow-Up
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Purpose: This study aimed to analyze radiological outcomes in patients with adolescent idiopathic scoliosis (AIS) who underwent posterior correction with high-density pedicle screw-only constructs. We hypothesized that high-density pedicle screw-only constructs in AIS would provide a high correction rate and would facilitate the maintenance of the correction or obviate the loss thereof. Materials and Methods: We retrospectively analyzed radiological outcomes over a minimum follow-up period of 5 years in patients with AIS who underwent posterior correction with high-density pedicle screw-only constructs. A total of 124 consecutive patients were included. Demographic data, including age, sex, operated fusion level, numbers of screw, Lenke curve type, Risser stage, and follow-up period were retrospectively collected from electronic medical records and radiological measurements including serial follow-up. Results: The average number of pedicle screws was 1.96/vertebra. The average curve correction was 48.3% for the proximal thoracic (PT) curve, 83.1% for the main thoracic (MT) curve, and 80.2% for the thoracolumbar/lumbar (TL/L) curve at final followup. Use of high-density pedicle screw-only constructs helped achieve excellent correction rates, with no significant loss of correction at final follow-up. Conclusion: We obtained excellent correction rates of 48.3% for PT, 83.1% for MT, and 80.2% for TL/L curves using high-density pedicle screw-only constructs in AIS, with no significant loss of correction at final follow-up.
Abstract
Purpose: This study aimed to analyze radiological outcomes in patients with adolescent idiopathic scoliosis (AIS) who underwent posterior correction with high-density pedicle screw-only constructs. We hypothesized that high-density pedicle screw-only constructs in AIS would provide a high correction rate and would facilitate the maintenance of the correction or obviate the loss thereof. Materials and Methods: We retrospectively analyzed radiological outcomes over a minimum follow-up period of 5 years in patients with AIS who underwent posterior correction with high-density pedicle screw-only constructs. A total of 124 consecutive patients were included. Demographic data, including age, sex, operated fusion level, numbers of screw, Lenke curve type, Risser stage, and follow-up period were retrospectively collected from electronic medical records and radiological measurements including serial follow-up. Results: The average number of pedicle screws was 1.96/vertebra. The average curve correction was 48.3% for the proximal thoracic (PT) curve, 83.1% for the main thoracic (MT) curve, and 80.2% for the thoracolumbar/lumbar (TL/L) curve at final followup. Use of high-density pedicle screw-only constructs helped achieve excellent correction rates, with no significant loss of correction at final follow-up. Conclusion: We obtained excellent correction rates of 48.3% for PT, 83.1% for MT, and 80.2% for TL/L curves using high-density pedicle screw-only constructs in AIS, with no significant loss of correction at final follow-up.
참고문헌 (33)
- Kepler CK, "Long-term outcomes after posterior spine fusion for adolescent idiopathic scoliosis", Curr Opin Pediatr, 24, pp.68~75 (2012)
- Suk SI, "Segmental pedicle screw fixation in the treatment of thoracic idiopathic scoliosis", Spine(Phila Pa 1976), 20, pp.1399~1405 (1995)
- Shufflebarger HL, "The posterior approach for lumbar and thoracolumbar adolescent idiopathic scoliosis: posterior shortening and pedicle screws", Spine(Phila Pa 1976), 29, pp.269~276 (2004)
- Hee HT, "Comparison of segmental pedicle screw instrumentation versus anterior instrumentation in adolescent idiopathic thoracolumbar and lumbar scoliosis", Spine(Phila Pa 1976), 32, pp.1533~1542 (2007)
- Li M, "Comparison of selective anterior versus posterior screw instrumentation in Lenke5C adolescent idiopathic scoliosis", Spine, 34, pp.1162~1166 (2009)
- Wang Y, "Anterior spinal fusion versus posterior spinal fusion for moderate lumbar", thoracolumbar adolescent idiopathic scoliosis: a prospective study, 2008, pp.33, 2166~2172
- Papin P, "Long-term three-dimensional changes of the spine after posterior spinal instrumentation and fusion in adolescent idiopathic scoliosis", Eur Spine J, 8, pp.16~21 (1999)
- Crawford AH, "All-pedicle screw versus hybrid instrumentation in adolescent idiopathic scoliosis surgery: a comparative radiographical study with a minimum 2-year follow-up", Spine(Phila Pa 1976), 38, pp.1199~1208 (2013)
- Hwang SW, "Five-year clinical and radiographic outcomes using pedicle screw only constructs in the treatment of adolescent idiopathic scoliosis", Eur Spine J, 22, pp.1292~1299 (2013)
- Uehara M, "Determination of optimal screw number based on correction angle for main thoracic curve in adolescent idiopathic scoliosis", J Orthop Sci, 24, pp.415~419 (2019)
- Lenke LG, "Curve prevalence of a new classification of operative adolescent idiopathic scoliosis : does classification correlate with treatment", Spine (Phila Pa 1976), 27, pp.604~611 (2002)
- Nash CL Jr, "A study of vertebral rotation", J Bone Joint Surg Am, 51, pp.223~229 (1969)
- Lee CS, "Thoracic pedicle screw insertion in scoliosis using posteroanterior C-arm rotation method", J Spinal Disord Tech, 20, pp.66~71 (2007)
- King HA, "The selection of fusion levels in thoracic idiopathic scoliosis", J Bone Joint Surg Am, 65, pp.1302~1313 (1983)
- Lenke LG, "The Lenke classification of adolescent idiopathic scoliosis: how it organizes curve patterns as a template to perform selective fusions of the spine", Spine(Phila Pa 1976), 28, pp.S199~S207 (2003)
- Lee CS, "Five major controversial issues about fusion level selection in corrective surgery for adolescent idiopathic scoliosis : a narrative review", Spine J, 17, pp.1033~1044 (2017)
- Cochran T, "Long-term anatomic and functional changes in patients with adolescent idiopathic scoliosis treated by Harrington rod fusion", Spine(Phila Pa 1976), 8, pp.576~584 (1983)
- Wood KB, "Rotational changes of the vertebral-pelvic axis following Cotrel-Dubousset instrumentation", Spine (Phila Pa 1976), 16(8 Suppl), pp.S404~S408 (1991)
- Suk SI, "Pedicle screw instrumentation in adolescent idiopathic scoliosis(AIS)", Eur Spine J, 21, pp.13~22 (2012)
- Suk SI, "Selective thoracic fusion with segmental pedicle screw fixation in the treatment of thoracic idiopathic scoliosis: more than 5-year follow-up", Spine(Phila Pa 1976), 30, pp.1602~1609 (2005)
- Kuklo TR, "Surgical revision rates of hooks versus hybrid versus screws versus combined anteroposterior spinal fusion for adolescent idiopathic scoliosis", Spine(Phila Pa 1976), 32, pp.2258~2264 (2007)
- Samdani AF, "Unplanned return to the operating room in patients with adolescent idiopathic scoliosis: are we doing better with pedicle screws?", Spine (Phila Pa 1976), 38, pp.1842~1847 (1976)
- Cheng I, "Apical sublaminar wires versus pedicle screws--which provides better results for surgical correction of adolescent idiopathic scoliosis?", Spine (Phila Pa 1976), 30, pp.2104~2112 (2005)
- Vora V, "A pedicle screw construct gives an enhanced posterior correction of adolescent idiopathic scoliosis when compared with other constructs: myth or reality", Spine(Phila Pa 1976), 32, pp.1869~1874 (2007)
- Clements DH, "Correlation of scoliosis curve correction with the number and type of fixation anchors", Spine(Phila Pa 1976), 34, pp.2147~2150 (2009)
- Hwang CJ, "Minimum 5-year follow-up results of skipped pedicle screw fixation for flexible idiopathic scoliosis", J Neurosurg Spine, 15, pp.146~150 (2011)
- Larson AN, "Does higher anchor density result in increased curve correction and improved clinical outcomes in adolescent idiopathic scoliosis?", Spine (Phila Pa 1976), 39, pp.571~578 (1976)
- Lehman RA Jr, "Operative treatment of adolescent idiopathic scoliosis with posterior pedicle screw-only constructs: minimum three-year follow-up of one hundred fourteen cases", Spine (Phila Pa 1976), 33, pp.1598~1604 (2008)
- Min K, "Posterior correction of thoracic adolescent idiopathic scoliosis with pedicle screw instrumentation : results of 48 patients with minimal 10-year follow-up", Eur Spine J, 22, pp.345~354 (2013)
- Uehara M, "Mid-term results of computer-assisted skip pedicle screw fixation for patients with Lenke type 1 and 2 adolescent idiopathic scoliosis : a minimum five-year follow-up study", J Orthop Sci, 23, pp.248~252 (2018)
- Yu CH, "Segmental correction of adolescent idiopathic scoliosis by all-screw fixation method in adolescents and young adults : minimum 5 years follow-up with SF-36 questionnaire", Scoliosis, 7, pp.5~ (2012)
- Lonner BS, "Multivariate analysis of factors associated with kyphosis maintenance in adolescent idiopathic scoliosis", Spine(Phila Pa 1976), 37, pp.1297~1302 (2012)
- Liu H, "Main thoracic curve adolescent idiopathic scoliosis : association of higher rod stiffness and concave-side pedicle screw density with improvement in sagittal thoracic kyphosis restoration", J Neurosurg Spine, 22, pp.259~266 (2015)
