Back Pain and Function 23 Years After Fusion for Adolescent Idiopathic Scoliosis: A Case-Control Study—Part II

Danielsson, Anna; Nachemson, Alf

doi:10.1097/01.brs.0000084267.41183.75

Cited by 181 publications

(106 citation statements)

References 73 publications

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“…Some series have reported slight increases or progression of radiographic parameters, but most have displayed evidence of correction maintenance with increased follow-up extending up to 20 years [1,[22][23][24][25]28]. Although several studies comparing earlier instrumentation systems have evaluated long-term surgical outcomes in AIS, the relatively recent innovation of thoracic pedicle screws has limited the longterm data available for pedicle screw-only constructs [1,2,21,22,26,27,29]. Using pedicle screw constructs, Suk et al [26] reported their surgical outcomes on 203 patients having undergone pedicle screw fixation with at least 5-year follow-up and noted a loss of 3 % correction of the main thoracic curve and a 5 % loss of correction of the unfused compensatory lumbar curve over time.…”

Section: Discussionmentioning

confidence: 99%

“…Instrumented correction of scoliotic deformities has evolved from Harrington rods, to Cotrel-Dubousset (CD) instrumentation, to the more recent advent of thoracic pedicle screw fixation [1][2][3][4][5][6]. Although Harrington rod distraction improved coronal deformity, sagittal plane imbalance was often associated with a high incidence of flatback syndrome [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

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Five-year clinical and radiographic outcomes using pedicle screw only constructs in the treatment of adolescent idiopathic scoliosis

et al. 2012

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Purpose To determine the mid-term clinical and radiographic impact of pedicle screw fixation in patients with adolescent idiopathic scoliosis (AIS). Methods A multicenter AIS database was retrospectively queried to identify 99 consecutive patients who underwent posterior spinal fusion using an all pedicle screw construct with a minimum of 5-year follow-up. Radiographic and clinical parameters were reviewed at regular intervals up to 5 years. ResultsThe mean age was 14.4 ± 2.0 years with 79 % being female. The mean preoperative major curve was 51.7 ± 14.2°with a mean correction of 66 and 64 % at 2 and 5 years (p = 0.16). Pre-op thoracic kyphosis averaged 22.3 ± 12.9°and was 18.4 ± 10.6°at 5 years with no significant change from 2 years (p = 0.33). SRS total and domain scores demonstrated significant improvements at 2 years, which were slightly decreased at 5 years (p = 0.06). SRS scores of self-image (p = 0.99) and satisfaction (p = 0.18) were significantly improved after surgery with minimal change by 5 years. The change in SRS total scores from 2 to 5 years was attributed to differences in SRS scores of pain and mental health (p \ 0.05). Conclusions Intermediate follow-up of patients with AIS treated with an all pedicle screw construct demonstrates maintenance of their coronal, and sagittal plane correction between 2-and 5-year follow-up. At 5 years, improvements in SRS scores were consistent with 2-year values, except for a decline in pain and mental health scores.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Five-year clinical and radiographic outcomes using pedicle screw only constructs in the treatment of adolescent idiopathic scoliosis

et al. 2012

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“…Although an instrumented spinal fusion provides better deformity correction than brace treatment, it is more invasive and thus carries more risk. [15][16][17][18][19][20][21][22] Fusion procedures, whether anterior, posterior, or both, require extensive surgical dissection to expose the spine and prepare for fusion. Bone graft harvest is also routinely necessary.…”

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confidence: 99%

The Use of Animal Models in Fusionless Scoliosis Investigations

Braun

Akyuz²,

Ogilvie³

2005

Spine

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Fusionless scoliosis surgery offers theoretical advantages over brace treatment and surgery. Like bracing, fusionless treatments preserve growth, motion, and function of the spine. Like surgery, these treatments offer substantial correction of deformity. However, minimally invasive fusionless scoliosis surgery is less extensive than fusion surgery and may avoid adjacent segment degeneration and other complications related to fusion. Additional investigations are required to identify optimal implant strategies, to evaluate the effects of these implants of the spine and surrounding structures, and to define the appropriate patient population for these interventions.

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“…Harrington rod application improved coronal deformity yet, sagittal deformity was almost associated flat-back syndrome [9] [10] [11]. The use of CD instrumentation improved outcomes, but correction of axial rotation remained questionable [3] [4] [5] [6]. Recently, the application of pedicle screws-used in all patients of this study-has improved upon many of the limitations from the preceding constructs and provided good maintenance of correction in the short-term [12]- [19].…”

Section: Introductionmentioning

confidence: 99%

Radiological Evaluation of Spinal Instrumentation as Treatment for Adolescent Idiopathic Scoliosis, a Single Saudi Center 5-Year Experience

Ali¹

2018

OJRad

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Aim of the Study: The aim of this work is to radiologically evaluate the postoperative outcomes of spinal instrumentation performed as a treatment for Adolescent Idiopathic Scoliosis (AIS) on 5-year follow up basis, and to correlate with different clinical scenarios. Materials and Methods: One hundred (100) AIS consecutive patients treated with spinal instrumentation were included in this study. The study period was from 2012 to 2017. All patients had radiological evaluations including total spine x-rays, low dose CT scan using Orthopedic Metal Artifact Reduction (OMAR) software and MRI, after obtaining the informed consents and approval of the institution ethical board. Radiological evaluation included Cobb angle measurement assessed pre, postoperatively and at regular intervals within the 5-year period. Results: Of the 100 patients included, 24 were females and 76 were males. The average age at operation was 16.5 years. Sixty seven (67%) patients showed good correction and maintenance of the spinal curves where the mean Cobb angle was 68˚ preoperatively and 21˚ postoperatively, representing a correction rate of 74%. Thirty three (33%) patients showed complications including postoperative infection (13), surgical revision (4), pseudarthrosis (3), neurological deficits (5), screw loosening (7) and complete hardware failure (1); in whom the preoperative mean Cobb angle was 56˚ compared to the patients with no complications (p = 0.288). In males, there were postoperative complications in 27 out of 76 and in females 5 out of 24, (p = 0.027). The average duration of follow-up was 3.7 years for all cases. Conclusion: Five-year follow up of patients with AIS treated with spinal instrumentation demonstrates good improvement and maintenance of the corrected spinal curves in two thirds of

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Back Pain and Function 23 Years After Fusion for Adolescent Idiopathic Scoliosis: A Case-Control Study—Part II

Cited by 181 publications

References 73 publications

Five-year clinical and radiographic outcomes using pedicle screw only constructs in the treatment of adolescent idiopathic scoliosis

Five-year clinical and radiographic outcomes using pedicle screw only constructs in the treatment of adolescent idiopathic scoliosis

The Use of Animal Models in Fusionless Scoliosis Investigations

Radiological Evaluation of Spinal Instrumentation as Treatment for Adolescent Idiopathic Scoliosis, a Single Saudi Center 5-Year Experience

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