Literature DB >> 23615383

Correction of Lenke 5 adolescent idiopathic scoliosis using pedicle screw instrumentation: does implant density influence the correction?

Jiayu Chen1, Changwei Yang, Bo Ran, Yunhua Wang, Chao Wang, Xiaodong Zhu, Yushu Bai, Ming Li.   

Abstract

STUDY
DESIGN: A single-center, retrospective study of 39 consecutive patients with Lenke 5 adolescent idiopathic scoliosis (AIS), all operated by a single surgeon using identical surgical technique and type of instrumentation (pedicle screws).
OBJECTIVE: The objective of this study is to evaluate the effect of implant density on coronal and sagittal correction in the treatment of Lenke 5 AIS. SUMMARY OF BACKGROUND DATA: There is an increasing trend in the use of pedicle screws in spinal corrective surgery. It is reported that decreased numbers of pedicle screws (low screw density) have no effects on the clinical outcomes for patients with Lenke 1 AIS. However, no previous studies have investigated the effects of reduced density of screw implantation on coronal correction and sagittal lumbar lordosis in patients with Lenke 5 AIS.
METHODS: Thirty-nine consecutive patients with Lenke 5 AIS underwent single-stage posterior correction and instrumented spinal fusion with pedicle screw fixation between 2006 and 2010. The radiographs were analyzed before surgery, immediately after surgery, and at the 2-year follow-up. General information of patients was recorded. Pearson correlation analysis was used to analyze the correlation between implant density, coronal Cobb angle correction, and correction index (postoperative correction/preoperative curve flexibility). The relations between implant density and magnitude of coronal and sagittal curve correction were also investigated.
RESULTS: The mean patient age at the time of operation was 14.5 years. The mean preoperative lumbar curve of 48.5° ± 9.2° was corrected to 13.7° ± 7.2° (72% correction) at a 2-year follow-up. There was a significant correlation between implant density and curve correction (r = 0.43, P < 0.05). No correlation was detected between implant density and correction index (r = -0.21, P = 0.20), and there was also no correlation between implant density and magnitude of sagittal curve correction (r = 0.065, P = 0.693).
CONCLUSION: Without curve flexibility taken into consideration, implant density is positively correlated with thoracolumbar or lumbar coronal Cobb curve correction. No significant correlation is found between screw density and correction index, if the effect of the flexibility was eliminated. There was no association between implant density and magnitude of sagittal curve correction before and after surgery.

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Year:  2013        PMID: 23615383     DOI: 10.1097/BRS.0b013e318297bfd4

Source DB:  PubMed          Journal:  Spine (Phila Pa 1976)        ISSN: 0362-2436            Impact factor:   3.468


  23 in total

1.  Skipped versus consecutive pedicle screw constructs for correction of Lenke 1 curves.

Authors:  Simon Morr; Alexandra Carrer; Luis Ignacio Alvarez-García de Quesada; Juan Carlos Rodriguez-Olaverri
Journal:  Eur Spine J       Date:  2015-01-20       Impact factor: 3.134

2.  Predictive factors for a distal adjacent disorder with L3 as the lowest instrumented vertebra in Lenke 5C patients.

Authors:  Kei Ando; Shiro Imagama; Zenya Ito; Kazuyoshi Kobayashi; Tetsuro Hida; Kenyu Ito; Akito Tsushima; Yoshimoto Ishikawa; Akiyuki Matsumoto; Yoshihiro Nishida; Naoki Ishiguro
Journal:  Eur J Orthop Surg Traumatol       Date:  2016-01

3.  Optimal surgical care for adolescent idiopathic scoliosis: an international consensus.

Authors:  Marinus de Kleuver; Stephen J Lewis; Niccole M Germscheid; Steven J Kamper; Ahmet Alanay; Sigurd H Berven; Kenneth M Cheung; Manabu Ito; Lawrence G Lenke; David W Polly; Yong Qiu; Maurits van Tulder; Christopher Shaffrey
Journal:  Eur Spine J       Date:  2014-06-24       Impact factor: 3.134

4.  Criteria for successful correction of thoracolumbar/lumbar curves in AIS patients: results of risk model calculations using target outcomes and failure analysis.

Authors:  Heiko Koller; Oliver Meier; Wolfgang Hitzl
Journal:  Eur Spine J       Date:  2014-06-18       Impact factor: 3.134

5.  Posterior-only correction of Scheuermann kyphosis using pedicle screws: economical optimization through screw density reduction.

Authors:  Eyal Behrbalk; Ofir Uri; Ruth M Parks; Michael Paul Grevitt; Marcus Rickert; Bronek Maximilian Boszczyk
Journal:  Eur Spine J       Date:  2014-08-08       Impact factor: 3.134

Review 6.  Does image guidance decrease pedicle screw-related complications in surgical treatment of adolescent idiopathic scoliosis: a systematic review update and meta-analysis.

Authors:  Andrew Chan; Eric Parent; Jason Wong; Karl Narvacan; Cindy San; Edmond Lou
Journal:  Eur Spine J       Date:  2019-11-28       Impact factor: 3.134

7.  Lowest instrumented vertebrae selection for selective posterior fusion of moderate thoracolumbar/lumbar idiopathic scoliosis: lower-end vertebra or lower-end vertebra+1?

Authors:  Zhijian Sun; Guixing Qiu; Yu Zhao; Yipeng Wang; Jianguo Zhang; Jianxiong Shen
Journal:  Eur Spine J       Date:  2014-03-25       Impact factor: 3.134

8.  The implant density does not change the correction rate of the main and the accompanying curves: A comparison between consecutive and intermittent pedicle screw constructs.

Authors:  Alpaslan Şenköylü; Mehmet Çetinkaya; İsmail Daldal; Ali Eren; Erdem Aktaş
Journal:  Acta Orthop Traumatol Turc       Date:  2020-05       Impact factor: 1.511

9.  Correction of Adolescent Idiopathic Scoliosis Using a Convex Pedicle Screw Technique: A Novel Technique for Deformity Correction.

Authors:  Athanasios I Tsirikos
Journal:  JBJS Essent Surg Tech       Date:  2019-03-13

10.  Influence of implant density and flexibility index on curve correction after scoliosis surgery.

Authors:  J M Wolfram; V A Kristen; J Cip; C M Bach
Journal:  Musculoskelet Surg       Date:  2021-03-22
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