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Radiographic and Functional Outcome in Adolescent Idiopathic Scoliosis Operated With Hook/Hybrid Versus All-Pedicle Screw Instrumentation-A Retrospective Study in 149 Patients

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  1. Revision Risk After Primary Adult Spinal Deformity Surgery: A Nationwide Study With Two-Year Follow-up

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  2. Sagittal Alignment After Surgical Treatment of Adolescent Idiopathic Scoliosis-Application of the Roussouly Classification

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  1. Evaluation of a new sagittal classification system in adolescent idiopathic scoliosis

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  2. Use of Opioids and Other Analgesics Before and After Primary Surgery for Adult Spinal Deformity: A 10-Year Nationwide Study

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STUDY DESIGN: Retrospective cohort study.

OBJECTIVE: To compare radiographic outcome and health-related quality of life in patients with adolescent idiopathic scoliosis (AIS) treated with hook/hybrid (H/H) or all-pedicle screw (PS) instrumentation.

SUMMARY OF BACKGROUND DATA: PS instrumentation has largely replaced H/H in the surgical treatment of AIS but whether a normalized sagittal profile can be obtained with the PS construct is still debated. Additionally, comparative studies assessing HRQL and surgical complications are needed.

METHODS: Two consecutive series of surgically treated AIS patients were included. Surgical treatment consisted of H/H or low-profile all-PS instrumentation. Radiographic and clinical follow-up, including SRS-22r questionnaires, was performed a minimum of two years postoperatively.

RESULTS: There were 85 and 64 patients in the H/H and PS group, respectively. The groups did not differ on baseline parameters apart from a lower flexibility in the H/H group (34% ± 14% vs. 39% ± 14% in the PS group, p = .026). Mean curve correction at final follow-up was 31% ± 13% versus 49% ± 12% in the H/H and PS group, respectively (p < .001), and mean loss of correction was 7° versus 4° (p < .001). The Cincinnati correction index was significantly higher in the PS group at final follow-up (p < .001). Postoperative thoracic kyphosis was significantly higher in the H/H group (27° ± 11° vs. 22° ± 11° in the PS group) with a mean change in kyphosis of 3° ± 9° versus -3° ± 12° in the H/H and PS group, respectively. SRS-22 scores did not differ between the two groups (p > .090), and the reoperation rate at final follow-up was 9% in the H/H group and 6% in the PS group (p = .556).

CONCLUSIONS: In a large consecutive cohort of AIS patients followed for a minimum of two years, we found a significantly better curve correction and less loss of correction with PS instrumentation compared to H/H. There was no significant difference in SRS-22r scores at final follow-up.

LEVEL OF EVIDENCE: Level III.

Original languageEnglish
JournalSpine Deformity
Volume5
Issue number6
Pages (from-to)401-408
Number of pages8
DOIs
Publication statusPublished - Nov 2017

    Research areas

  • Journal Article

ID: 52757182