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.

Abstract

PURPOSE:

In skip pedicle screw fixation for adolescent idiopathic scoliosis (AIS), the mid-term effects of reducing screw number on correction and clinical results are uncertain. We clarified the mid-term outcomes of this technique in patients with Lenke type 1 and 2 AIS.

METHODS:

Thirty-four patients who underwent skip pedicle screw fixation (mean screw density: 1.35 screws) for Lenke type 1 and 2 AIS were retrospectively reviewed. The follow-up period was at least 5 years (mean follow-up period: 6.1 years), and the follow-up rate was 89.5%. Radiological parameters and clinical symptoms were evaluated before, immediately after, and at 2 years and 5 years after surgery.

RESULTS:

The mean Cobb angle of the main thoracic (MT) curve before, immediately after, at 2 years after surgery, and at the final 5-year minimum follow-up was 52.5°, 16.4°, 20.5°, and 19.4°, respectively. The Cobb angle of the MT curve was significantly improved immediately after, at 2 years after surgery, and at the final follow-up compared with that before surgery (p < 0.01). The mean correction rate immediately after surgery was 69.0% and the rate of correction loss at the final follow-up was 8.3%. All Scoliosis Research Society-22 patient questionnaire (SRS-22r) sub scores 5 years after surgery were significantly improved compared with those beforehand (p < 0.01).

CONCLUSIONS:

Correction using skip pedicle screw fixation in AIS was well maintained from the initial follow-up measurements to the final follow-up. The SRS-22r sub scores at the final follow-up were significantly improved over preoperative levels.

• Authors: Masashi Uehara, Jun Takahashi, Shota Ikegami, Shugo Kuraishi, Toshimasa Futatsugi, Hiroki Oba, Michihiko Koseki, Hiroyuki Kato
• Journal: Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association (J Orthop Sci) Vol. 23 Issue 2 Pg. 248-252 (Mar 2018) ISSN: 1436-2023 [Electronic] Japan
• PMID: 29198598 (Publication Type: Journal Article)
• Copyright: Copyright © 2017 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

Topics

• Adolescent
• Cohort Studies
• Female
• Follow-Up Studies
• Humans
• Male
• Pain Measurement
• Pedicle Screws
• Quality of Life
• Radiography, Thoracic (methods)
• Recovery of Function
• Retrospective Studies
• Risk Assessment
• Scoliosis (diagnostic imaging, surgery)
• Severity of Illness Index
• Spinal Fusion (instrumentation, methods)
• Surgery, Computer-Assisted (methods)
• Time Factors
• Tomography, X-Ray Computed (methods)
• Treatment Outcome