STUDY DESIGN: Retrospective, case-control, matched cohort. OBJECTIVE: Compare the radiographic and clinical outcomes of adult spinal deformity patients treated with thoracic pedicle screw (TPS) or thoracic hook constructs. SUMMARY OF BACKGROUND DATA: The efficacy of TPS instrumentation for pediatric spinal deformity correction has been established. Little is known about TPS use in adult spinal deformity. METHODS: Fifty-six patients (average age, 49 years; average follow-up, 3.58 years) were treated with TPS or thoracic hook constructs for coronal (n = 20) or sagittal (n = 36) plane deformities. Patients were evaluated radiographically and with SRS scores. RESULTS: Coronal deformities treated with TPS demonstrated improved main thoracic curve correction compared with hook constructs at last follow-up (24.8 degrees vs. 13.8 degrees; P < 0.05), despite having larger (59.8 degrees vs. 44.9 degrees; P < 0.05) and more rigid preoperative curves (29.3% vs. 44.9% correction on side-bending radiographs; P < 0.001). Sagittal deformities treated with TPS constructs demonstrated greater thoracolumbar kyphosis correction than hook constructs at last follow-up (12.1 degrees vs. 2.5 degrees; P < 0.05). No TPS patient had a thoracic pseudarthrosis. Four hook patients (14%) had thoracic pseudarthroses. CONCLUSIONS: TPS instrumentation allows greater coronal and sagittal plane correction and may reduce the risk of thoracic pseudarthrosis compared with hook constructs when treating adult spinal deformities.
STUDY DESIGN: Retrospective, case-control, matched cohort. OBJECTIVE: Compare the radiographic and clinical outcomes of adult spinal deformitypatients treated with thoracic pedicle screw (TPS) or thoracic hook constructs. SUMMARY OF BACKGROUND DATA: The efficacy of TPS instrumentation for pediatric spinal deformity correction has been established. Little is known about TPS use in adult spinal deformity. METHODS: Fifty-six patients (average age, 49 years; average follow-up, 3.58 years) were treated with TPS or thoracic hook constructs for coronal (n = 20) or sagittal (n = 36) plane deformities. Patients were evaluated radiographically and with SRS scores. RESULTS:Coronal deformities treated with TPS demonstrated improved main thoracic curve correction compared with hook constructs at last follow-up (24.8 degrees vs. 13.8 degrees; P < 0.05), despite having larger (59.8 degrees vs. 44.9 degrees; P < 0.05) and more rigid preoperative curves (29.3% vs. 44.9% correction on side-bending radiographs; P < 0.001). Sagittal deformities treated with TPS constructs demonstrated greater thoracolumbar kyphosis correction than hook constructs at last follow-up (12.1 degrees vs. 2.5 degrees; P < 0.05). No TPS patient had a thoracic pseudarthrosis. Four hook patients (14%) had thoracic pseudarthroses. CONCLUSIONS: TPS instrumentation allows greater coronal and sagittal plane correction and may reduce the risk of thoracic pseudarthrosis compared with hook constructs when treating adult spinal deformities.
Authors: Andrea Zanirato; Marco Damilano; Matteo Formica; Andrea Piazzolla; Alessio Lovi; Jorge Hugo Villafañe; Pedro Berjano Journal: Eur Spine J Date: 2018-03-01 Impact factor: 3.134
Authors: Tamás Fülöp Fekete; Frank S Kleinstück; Anne F Mannion; Zsolt S Kendik; Dezso J Jeszenszky Journal: Eur Spine J Date: 2011-07-16 Impact factor: 3.134
Authors: Lawrence G Lenke; Christopher I Shaffrey; Leah Y Carreon; Kenneth M C Cheung; Benny T Dahl; Michael G Fehlings; Christopher P Ames; Oheneba Boachie-Adjei; Mark B Dekutoski; Khaled M Kebaish; Stephen J Lewis; Yukihiro Matsuyama; Hossein Mehdian; Ferran Pellisé; Yong Qiu; Frank J Schwab Journal: J Bone Joint Surg Am Date: 2018-04-18 Impact factor: 5.284