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

Abstract

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.

Blood transfusion in the surgical treatment of adolescent idiopathic scoliosis—a single‐center experience of patient blood management in 210 cases

“…In patients with adolescent idiopathic scoliosis (AIS), surgical treatment involves a posterior approach with multisegmental pedicle screw fixation . Although this procedure is generally considered safe with few surgical complications, there are considerable variations in fusion length, surgical time, and the extent of soft‐tissue exposure . Consequently, perioperative blood loss can be substantial, and the use of intraoperative and postoperative RBC transfusions are frequently required .…”

Preservation of Spine Motion in the Surgical Treatment of Adolescent Idiopathic Scoliosis Using an Innovative Apical Fusion Technique: A 2-Year Follow-Up Pilot Study

“…[22][23][24] Improved understanding of the forces acting on the deformity 2,25 has led to refinements of correction strategies, fixation devices, and implant materials. 4,7,[26][27][28][29][30][31][32][33] More recently, the possibilities of shortening the required arthrodesis [33][34][35] using less soft tissue dissection, 16,36 and using fewer implants 18,37-40 have been investigated in an effort to decrease fusion-related morbidity, 13,14 retain maximum spinal motion, and decrease costs. 17 The concept of dynamic segmental fixation to guide spinal growth without fusion has also been explored.…”

Surgical treatment of children with idiopathic thoracolumbar scoliosis using transpedicular spinal systems

“…Оперативное вмешательство позволяет добиться коррекции деформации по-звоночника, улучшения или восстановления фи-зиологического баланса туловища, надежной ста-билизации достигнутого результата при помощи многоопорной металлоконструкции и, как резуль-тат, улучшения качества жизни пациента [1][2][3]. При лечении детей с идиопатическим сколиозом в последнее время стали применять многоопор-ные спинальные системы с транспедикулярны-ми опорными элементами [4][5][6][7][8][9][10][11]. Использование данного типа металлоконструкций обеспечивает возможность воздействия на все три опорные ко-лонны деформированного позвоночного столба, эффективной коррекции сколиотического и ки-фотического компонентов искривления и при-ближения к физиологическому фронтальному и сагиттальному профилям позвоночника в ходе операции.…”