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Posterior scoliosis correction for adolescent idiopathic scoliosis using side-opening pedicle screw-rod system utilizing the axial translation technique.

Basu S, Rathinavelu S, Baid P - Indian J Orthop (2010)

Bottom Line: The values of mean pre- and postoperative scores are 3.68 and 4.18, showing an improvement of 0.5 points.No patient had neurological deterioration.Side-opening spinal instrumentation systems, using the axial translation technique, achieved good clinical and radiological outcome for patients of AIS.

View Article: PubMed Central - PubMed

Affiliation: Park Clinic, Neurosciences Division, Kolkata, India.

ABSTRACT

Background: Though adequate literature is present depicting the results of pedicle screw-rod instrumentation using top loading systems for correction of adolescent idiopathic scoliosis (AIS), using the rod rotation technique, few published data is available regarding side loading systems used for a similar purpose. We report a retrospective study of a cohort of patients with strict inclusion criteria who underwent surgical correction of AIS with side-opening pedicle screw-rod posterior instrumentation using the axial translation technique of curve correction to assess the efficacy of side opening system for scoliosis correction with regards to patient satisfaction, Cobb's angle correction and spinal balance.

Materials and methods: Clinical and radiological outcomes were measured in 14 consecutive patients (3 males, 11 females) with an average age of 14.0 years (range 9 to 23 years). They were followed up for an average period of 13.0 months (range - 2.2 to 28.5). All patients underwent posterior instrumentation only with pedicle screws used as anchor points. Hybrid constructs using hooks/wires or curves requiring anterior release were excluded from the study. All levels were not instrumented - more screws were put on the concavity and in the peri-apical region. Radiological evaluation was done by whole spine standing AP, lateral radiograms preoperatively and 1, 3, 6 and12 months after surgery. Cobb's angles were measured and the spinal balance was noted. Clinical evaluation was done by SRS questionnaire. The complications were documented.

Results: The mean preoperative Cobb's angle was 58.35 degrees (range - 44 to 72 degrees ), which came down postoperatively to 23.45 degrees (range - 10 to 38 degrees ) signifying a mean correction of 59.57% (range - 26.92 to 76.17%). Clinical outcomes were evaluated using the SRS - 30 questionnaires. The values of mean pre- and postoperative scores are 3.68 and 4.18, showing an improvement of 0.5 points. Other than one patient of superficial wound infection, which healed with antibiotics, there was no major complication. No patient had neurological deterioration.

Conclusion: Side-opening spinal instrumentation systems, using the axial translation technique, achieved good clinical and radiological outcome for patients of AIS.

No MeSH data available.


Related in: MedlinePlus

Clinical picture (a) and whole spine anteroposterior (b) and lateral (c) radiographs showing typical King Type I curve with Cobb's angle of 70° (thoracic) and 72° (Lumbar). Follow up clinical picture (d) and radiograph anteroposterior (e) and lateral (f) showing good correction and reduction of Cobb's angle to 20° (thoracic) and 18° (Lumbar)
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Figure 0001: Clinical picture (a) and whole spine anteroposterior (b) and lateral (c) radiographs showing typical King Type I curve with Cobb's angle of 70° (thoracic) and 72° (Lumbar). Follow up clinical picture (d) and radiograph anteroposterior (e) and lateral (f) showing good correction and reduction of Cobb's angle to 20° (thoracic) and 18° (Lumbar)

Mentions: Medical case sheets and investigations including X rays and MRI of the patients were studied retrospectively. The patient details are shown in Table 1. All the patients were available for follow-up. The average follow-up period is 13 months (range 10 to 24 months). There were 3 males and 11 females. The average age was 14 years (range 9 to 23 years). King and Moe classification system5 was followed. There were four patients with Type 1 curve [Figure 1], two with Type 2 curve [Figure 2a and b], five patients with Type 3 curve [Figure 3] and three patients with Type 4 curve [Figure 4], [Table 1]. There were no Type V patients in our series.


Posterior scoliosis correction for adolescent idiopathic scoliosis using side-opening pedicle screw-rod system utilizing the axial translation technique.

Basu S, Rathinavelu S, Baid P - Indian J Orthop (2010)

Clinical picture (a) and whole spine anteroposterior (b) and lateral (c) radiographs showing typical King Type I curve with Cobb's angle of 70° (thoracic) and 72° (Lumbar). Follow up clinical picture (d) and radiograph anteroposterior (e) and lateral (f) showing good correction and reduction of Cobb's angle to 20° (thoracic) and 18° (Lumbar)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2822418&req=5

Figure 0001: Clinical picture (a) and whole spine anteroposterior (b) and lateral (c) radiographs showing typical King Type I curve with Cobb's angle of 70° (thoracic) and 72° (Lumbar). Follow up clinical picture (d) and radiograph anteroposterior (e) and lateral (f) showing good correction and reduction of Cobb's angle to 20° (thoracic) and 18° (Lumbar)
Mentions: Medical case sheets and investigations including X rays and MRI of the patients were studied retrospectively. The patient details are shown in Table 1. All the patients were available for follow-up. The average follow-up period is 13 months (range 10 to 24 months). There were 3 males and 11 females. The average age was 14 years (range 9 to 23 years). King and Moe classification system5 was followed. There were four patients with Type 1 curve [Figure 1], two with Type 2 curve [Figure 2a and b], five patients with Type 3 curve [Figure 3] and three patients with Type 4 curve [Figure 4], [Table 1]. There were no Type V patients in our series.

Bottom Line: The values of mean pre- and postoperative scores are 3.68 and 4.18, showing an improvement of 0.5 points.No patient had neurological deterioration.Side-opening spinal instrumentation systems, using the axial translation technique, achieved good clinical and radiological outcome for patients of AIS.

View Article: PubMed Central - PubMed

Affiliation: Park Clinic, Neurosciences Division, Kolkata, India.

ABSTRACT

Background: Though adequate literature is present depicting the results of pedicle screw-rod instrumentation using top loading systems for correction of adolescent idiopathic scoliosis (AIS), using the rod rotation technique, few published data is available regarding side loading systems used for a similar purpose. We report a retrospective study of a cohort of patients with strict inclusion criteria who underwent surgical correction of AIS with side-opening pedicle screw-rod posterior instrumentation using the axial translation technique of curve correction to assess the efficacy of side opening system for scoliosis correction with regards to patient satisfaction, Cobb's angle correction and spinal balance.

Materials and methods: Clinical and radiological outcomes were measured in 14 consecutive patients (3 males, 11 females) with an average age of 14.0 years (range 9 to 23 years). They were followed up for an average period of 13.0 months (range - 2.2 to 28.5). All patients underwent posterior instrumentation only with pedicle screws used as anchor points. Hybrid constructs using hooks/wires or curves requiring anterior release were excluded from the study. All levels were not instrumented - more screws were put on the concavity and in the peri-apical region. Radiological evaluation was done by whole spine standing AP, lateral radiograms preoperatively and 1, 3, 6 and12 months after surgery. Cobb's angles were measured and the spinal balance was noted. Clinical evaluation was done by SRS questionnaire. The complications were documented.

Results: The mean preoperative Cobb's angle was 58.35 degrees (range - 44 to 72 degrees ), which came down postoperatively to 23.45 degrees (range - 10 to 38 degrees ) signifying a mean correction of 59.57% (range - 26.92 to 76.17%). Clinical outcomes were evaluated using the SRS - 30 questionnaires. The values of mean pre- and postoperative scores are 3.68 and 4.18, showing an improvement of 0.5 points. Other than one patient of superficial wound infection, which healed with antibiotics, there was no major complication. No patient had neurological deterioration.

Conclusion: Side-opening spinal instrumentation systems, using the axial translation technique, achieved good clinical and radiological outcome for patients of AIS.

No MeSH data available.


Related in: MedlinePlus