Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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BackgroundIn our institution, the fixation technique in treating idiopathic scoliosis was shifted from hybrid fixation to the all-screw method beginning in 2000. We conducted this study to assess the intermediate -term outcome of all-screw method in treating adolescent idiopathic scoliosis (AIS).MethodsForty-nine consecutive patients were retrospectively included with minimum of 5-year follow-up (mean, 6.1; range, 5.1-7.3 years). The average age of surgery was 18.5 ± 5.0 years. We assessed radiographic measurements at preoperative (Preop), postoperative (PO) and final follow-up (FFU) period. Curve correction rate, correction loss rate, complications, accuracy of pedicle screws and SF-36 scores were analyzed.ResultsThe average major curve was corrected from 58.0 ± 13.0° Preop to 16.0 ± 9.0° PO(p < 0.0001), and increased to 18.4 ± 8.6°(p = 0.12) FFU. This revealed a 72.7% correction rate and a correction loss of 2.4° (3.92%). The thoracic kyphosis decreased little at FFU (22 ± 12° to 20 ± 6°, (p = 0.25)). Apical vertebral rotation decreased from 2.1 ± 0.8 PreOP to 0.8 ± 0.8 at FFU (Nash-Moe grading, p < 0.01). Among total 831 pedicle screws, 56 (6.7%) were found to be malpositioned. Compared with 2069 age-matched Taiwanese, SF-36 scores showed inferior result in 2 variables: physical function and role physical.ConclusionFollow-up more than 5 years, the authors suggest that all-screw method is an efficient and safe method.

Intramedullary nailing is a common treatment for long bone fractures. The nail might deform during implantation because of the shape of medullary cavity. Thus, surgeons take many X‐ray images to position distal locking holes and check the drilling process. In this study, we developed a positioning algorithm with a passive or active (robot arm) assistive device for promptly positioning of distal locking holes and stably drilling guidance and support. Using the passive device, the surgeon could manually align the positioning probe with locking hole within 60 seconds based on 20 test cases. In 36 test cases, the active device aligned the positioning probe with locking hole automatically with average errors of 2.2 mm in position and 3.19° in direction. The passive device provides a reliable and low‐cost solution for distal locking of intramedullary nails, while the active device is easy and friendly to use.

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