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Three-dimensional analysis of spinal deformity correction in adolescent idiopathic scoliosis: comparison of two distinct techniques

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Abstract

Purpose

To compare 3D postoperative deformity correction using two distinct commonly utilized techniques for the treatment of adolescent idiopathic scoliosis (AIS).

Methods

AIS patients with major thoracic (Lenke 1–2) curves at two sites who underwent deformity correction via posterior spinal instrumented fusion using one of two distinct techniques were retrospectively reviewed. Patients were matched 1:1 between sites for Lenke type (95% Lenke 1) and follow-up time. The “band site” performed posteromedial translation using thoracic sublaminar bands and 5.5-mm rods. The “screw site” performed spine derotation using differential rod contouring with pedicle screws and 5.5-mm rods. 3D measures of deformity from spinal reconstructions were compared between sites.

Results

Preoperatively, the groups had similar thoracic curve magnitudes (band, 55 ± 12° vs. screw, 52 ± 10°; p > 0.05); the “screw site” had less T5–T12 kyphosis (2 ± 14° vs. 7 ± 12°, p = 0.05) and greater thoracic apical rotation (− 19 ± 7° vs. − 14 ± 8°, p = 0.007). Postoperatively, the “screw site” had greater percent correction (61% vs. 76%, p < 0.001) and kyphosis restoration (p = 0.002). The groups achieved a similar amount of apical derotation (p = 0.9). The “band site” used cobalt chromium rods exclusively; the “screw site” used cobalt chromium (3%) and stainless steel (97%; p < 0.001). The “band site” performed significantly longer fusions.

Conclusions

Significant variations were found between two commonly utilized techniques in AIS surgery, including rod material, correction mechanisms, and fusion levels. Significantly, a greater 3D deformity correction of the coronal and sagittal planes was observed at the “screw site” compared to the “band site”, but with no difference in axial plane correction.

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Funding

This study was supported in part by grants to the Setting Scoliosis Straight Foundation in support of Harms Study Group research from DePuy Synthes Spine, EOS imaging, K2M, Medtronic, NuVasive, and Zimmer Biomet.

Author information

Authors and Affiliations

  1. Department of Orthopaedics, University of California, San Diego, CA, USA

    Jakub Sikora-Klak, Vidyadhar V. Upasani, Burt Yaszay & Peter O. Newton

  2. Department of Orthopedics, Rady Children’s Hospital, 3030 Children’s Way, San Diego, CA, 92123, USA

    Vidyadhar V. Upasani, Madeline Cross, Tracey P. Bastrom, Burt Yaszay & Peter O. Newton

  3. Department of Orthopedics, Paris Diderot University, Paris, France

    Brice Ilharreborde & Keyvan Mazda

Authors
  1. Jakub Sikora-Klak
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  2. Vidyadhar V. Upasani
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  3. Brice Ilharreborde
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  4. Madeline Cross
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  5. Tracey P. Bastrom
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  6. Keyvan Mazda
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  7. Burt Yaszay
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  8. Peter O. Newton
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Corresponding author

Correspondence to Vidyadhar V. Upasani.

Ethics declarations

IRB approval was obtained for this study.

Conflict of interest

Dr. Sikora-Klak reports no conflict of interest.

Dr. Upasani reports grants to his institution from Setting Scoliosis Straight Foundation, during the conduct of this study; personal fees from DePuy Synthes Spine, personal fees from OrthoPediatrics, outside the submitted work.

Dr. Ilharreborde reports personal fees from Implanet, personal fees from Medtronic, personal fees from Zimmer Biomet, outside the submitted work.

Ms. Cross reports no conflict of interest.

Ms. Bastrom reports grants to her institution from Setting Scoliosis Straight Foundation, during the conduct of the study.

Dr. Mazada reported no conflict of interest.

Dr. Yaszay reports grants to his institution from Setting Scoliosis Straight Foundation, during the conduct of the study; grants and personal fees from K2M, grants and personal fees from DePuy Synthes Spine, grants and personal fees from Nuvasive, personal fees from Medtronic, grants and personal fees from Orthopediatrics, personal fees from Stryker, personal fees from Globus, grants from Setting Scoliosis Straight Foundation, personal fees from Biogen, outside the submitted work; In addition, Dr. Yaszay has a patent K2M with royalties paid.

Dr. Newton reports grants to his institution from Setting Scoliosis Straight Foundation (SSSF receives grants from DePuy Synthes Spine, EOS imaging, K2M, Medtronic, NuVasive and Zimmer Biomet in support of Harms Study Group research), during the conduct of the study; grants and other from Setting Scoliosis Straight Foundation, other from Rady Children’s Specialists, grants, personal fees and non-financial support from DePuy Synthes Spine, grants and other from SRS, grants from EOS imaging, personal fees from Thieme Publishing, grants from NuVasive, other from Electrocore, personal fees from Cubist, other from International Pediatric Orthopedic Think Tank, grants, non-financial support and other from Orthopediatrics, grants, personal fees and non-financial support from K2M, grants and non-financial support from Alphatech, grants from Mazor Robotics, outside the submitted work; In addition, Dr. Newton has a patent Anchoring systems and methods for correcting spinal deformities (8540754) with royalties paid to DePuy Synthes Spine, a patent Low profile spinal tethering systems (8123749) licensed to DePuy Spine, Inc., a patent Screw placement guide (7981117) licensed to DePuy Spine, Inc., a patent Compressor for use in minimally invasive surgery (7189244) licensed to DePuy Spine, Inc., and a patent Posterior spinal fixation pending to K2M.

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This study was conducted at Rady Children’s Hospital, San Diego, CA.

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Sikora-Klak, J., Upasani, V.V., Ilharreborde, B. et al. Three-dimensional analysis of spinal deformity correction in adolescent idiopathic scoliosis: comparison of two distinct techniques. Childs Nerv Syst 37, 555–560 (2021). https://doi.org/10.1007/s00381-020-04868-0

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