Study Design: Retrospective case series.
Objectives: To compare radiographic and clinical outcomes in posterior spine fusions with pedicle screw instrumentation of varying screw densities in the treatment of adolescent idiopathic scoliosis (AIS).
Summary Of Background Data: Posterior spinal fusion with pedicle screw instrumentation is the mainstay of surgical treatment for AIS. The most commonly used construct consists of screws placed at every level on the concave side of the deformity and nearly every level on the convex side. However, some surgeons have begun using constructs with fewer pedicle screws. The literature comparing outcomes of these differing pedicle screw constructs is limited.
Methods: Fifty-two consecutive cases of posterior spinal fusions for AIS performed by four surgeons were reviewed. High screw density constructs were used in 26 cases and limited screw density constructs in 26 cases. Construct characteristics and radiographic measurements were compared preoperatively and at last follow-up. Operative time and estimated costs were also evaluated. Student t tests were used to compare the groups with p < .05 considered significant.
Results: There was no significant difference in magnitude of correction for the high versus limited screw density group initially (38.5° vs. 34.9°, p = .093) or at final follow-up (36.9° vs. 32.2°, p = .054). Sagittal alignment, coronal balance, and translation of the major apical vertebra were comparable and stable in both groups. The high versus limited screw density group utilized significantly more pedicle screws (16.8 vs. 11.6 screws, p < .0001), had longer operative times (309 vs. 267 minutes, p = .007), and had additional estimated direct costs of $5,800.
Conclusions: Excellent curve correction, stability, and balance can be achieved using fewer screws than commonly used in posterior pedicle screw fusions for AIS. Operative time is reduced, and risk and cost are decreased with the use of limited screw density constructs.
Level Of Evidence: III.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jspd.2015.07.010 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Estimation of Dislocation Densities With Nondestructive Scanning Electron Microscope Techniques: Application to Gallium Nitride.
Microsc Microanal
January 2025
Université de Lorraine, CNRS, Arts et Métiers, LEM3, Metz 57070, France.
Characterizing threading dislocations (TDs) in gallium nitride (GaN) semiconductors is crucial for ensuring the reliability of semiconductor devices. The current research addresses this issue by combining two techniques using a scanning electron microscope, namely electron channeling contrast imaging (ECCI) and high-resolution electron backscattered diffraction (HR-EBSD). It is a comparative study of these techniques to underscore how they perform in the evaluation of TD densities in GaN epitaxial layers.
View Article and Find Full Text PDFThe MRI-based vertebral bone quality score is a predictor of pedicle screw loosening following instrumented posterior lumbar fusion.
Sci Rep
January 2025
Department of Orthopedic Surgery, Chang Gung Memorial Hospital, No. 5, Fuxing St., Guishan Dist, Linkou, Taoyuan, 33305, Taiwan.
Objective: To investigate the predictive ability of the MRI-based vertebral bone quality (VBQ) score for pedicle screw loosening following instrumented transforaminal lumbar interbody fusion (TLIF).
Methods: Data from patients who have received one or two-level instrumented TLIF from February 2014 to March 2015 were retrospectively collected. Pedicle screw loosening was diagnosed when the radiolucent zone around the screw exceeded 1 mm in plain radiographs.
Biomechanical insights into anterolateral vertebral screw fixation in osteoporotic spines: a comparative study of fixation methods and positions using porcine vertebrae.
J Orthop Surg Res
January 2025
Department of Orthopaedic Surgery, Spine Section, Bone and Joint Research Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Objective: Combining oblique lumbar interbody fusion (OLIF) with posterior pedicle screw fixation (PPSF) has been proposed to reduce cage subsidence, especially in osteoporotic spines. Recently, anterolateral screw-rod fixation has gained interest as it allows direct pathology observation and avoids a posterior approach. However, controversies exist between anterolateral screw fixation systems and traditional PPSF due to variations in osteoporotic vertebral mineral density, screw fixation positions, and fixation methods (bicortical vs.
View Article and Find Full Text PDFThe Risk of Intravenous Cement Leakage and Short-term Outcomes of Selective Cement-augmented Pedicle Screws: A Multicenter Retrospective Study.
Clin Spine Surg
December 2024
Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjyuku, Tokyo.
Study Design: Multicenter retrospective cohort study.
Objective: To evaluate the efficacy and safety of using cement-augmented pedicle screw (CAPS) fixation only for the cephalad and caudal vertebral bodies.
Summary Of Background Data: Pedicle screw fixation is less effective in patients with low-quality bone.
The potential role of synthetic computed tomography in spinal surgery: generation, applications, and implications for future clinical practice.
Asian Spine J
December 2024
National Spinal Injuries Unit, Mater Misericordiae University Hospital, Dublin, Ireland.
Computed tomography (CT) is widely used for the diagnosis and surgical treatment of spinal pathologies, particularly for pedicle screw placement. However, CT's limitations, notably radiation exposure, necessitate the development of alternative imaging techniques. Synthetic CT (sCT), which generates CT-like images from existing magnetic resonance imaging (MRI) scans, offers a promising alternative to reduce radiation exposure.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!