Hybrid constructs pedicle screw with apical sublaminar bands versus pedicle screws only for surgical correction of adolescent idiopathic scoliosis

  • Matteo Palmisani
  • Eugenio Dema
  • Stefano Cervellati
  • Rosa Palmisani
Original Article

Abstract

Purpose

To compare the 2-year minimum postoperative results of posterior correction and spinal arthrodesis using translational correction with hybrid (sublaminar bands on concave side and pedicle screw) constructs versus correction with intermediate density pedicle screw-only constructs in the treatment of AIS (Lenke 1).

Methods

A total of 37 patients with AIS at single institutions who underwent posterior spinal arthrodesis pedicle screw with sublaminar bands at the apex (19 patients) (Group A) or pedicle screw-only (18) constructs (Group B) were selected and matched according to similar age at surgery 13.8 years (Group A) and 14.3 years (Group B), similar arthrodesis area 12.3 (Group A) and 11.5 (Group B), all curves Lenke type 1 with similar pre-op curve 54° (Group A) and 57° (Group B). Patients were evaluated pre-op, immediately post-op, and at min 2-year follow-up according to radiographic curve correction, operating time, intraoperative blood loss, and f.u. loss of correction.

Results

The average curve correction was 65.6% in sublaminar group and 68% in pedicle screw group. At 2-year follow-up, loss of the major curve correction was 2% in sublaminar group compared to 3% in pedicle screw group. Postoperative coronal and sagittal balance was similar in both groups. Operating time averaged 200 min (Group A) and 180 min (Group B). Intraoperative blood loss was significantly different in both groups 700 ± 160 cc in sublaminar group and 630 ± 150 cc in pedicle screw group. There were no neurologic complications in both groups.

Conclusion

The two groups offer similar curve correction without neurologic complications in the surgical treatment of AIS (Lenke 1). The use of sublaminar bands on the apex (concave side) can be a valid fixation in the presence of hypoplastic pedicle, can reduce the thoracic hypokyphosis and derotate the vertebra but had more blood loss comparing to pedicle screws alone.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

Keywords

Adolescent idiopathic scoliosis Surgical correction Sublaminar bands Pedicle screw 

Notes

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Supplementary material

586_2018_5625_MOESM1_ESM.pptx (952 kb)
Supplementary material 1 (PPTX 951 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Matteo Palmisani
    • 1
  • Eugenio Dema
    • 1
  • Stefano Cervellati
    • 1
  • Rosa Palmisani
    • 1
  1. 1.Scoliosis and Spinal Deformity CenterHesperia HospitalModenaItaly

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