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

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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.

Results

The 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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Conflict of interest

This study was supported by a research grant from Depuy Spine to the Setting Scoliosis Straight Foundation of the Harms Study Group.

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Authors and Affiliations

  1. Tufts Medical Center, Floating Hospital for Children, Boston, MA, USA

    Steven W. Hwang

  2. Shriners Hospital for Children, 3551 North Broad Street, Philadelphia, PA, 19140, USA

    Amer F. Samdani, James T. Bennett, Joshua Pahys & Randal Betz

  3. Rady Children’s Hospital and Health Center, San Diego, CA, USA

    Michelle Marks, Tracy Bastrom & Peter Newton

  4. Artemis Health Institute, Haryana, India

    Hitesh Garg

  5. NYU Hospital for Joint Diseases, New York, NY, USA

    Baron Lonner

  6. Alfred I. DuPont Hospital for Children, Wilmington, DE, USA

    Suken Shah

  7. BC Children’s Hospital, Vancouver, BC, USA

    Firoz Miyanji

  8. Miami Children’s Hospital, Miami, FL, USA

    Harry Shufflebarger

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  1. Steven W. Hwang
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  2. Amer F. Samdani
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  3. Michelle Marks
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  4. Tracy Bastrom
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  13. Randal Betz
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Corresponding author

Correspondence to Amer F. Samdani.

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Hwang, S.W., Samdani, A.F., Marks, M. et al. Five-year clinical and radiographic outcomes using pedicle screw only constructs in the treatment of adolescent idiopathic scoliosis. Eur Spine J 22, 1292–1299 (2013). https://doi.org/10.1007/s00586-012-2625-0

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  • DOI: https://doi.org/10.1007/s00586-012-2625-0

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