Curve Correction Not Influenced By Implant Density in Scoliosis

Bilateral segmental pedicle screw fixation results found similar to unilateral, alternate segmental fixation

TUESDAY, March 30 (HealthDay News) -- Segmental fixation via pedicle screw constructs assists in curve correction during scoliosis surgery, with unilateral or alternate attachment yielding results similar to the more extensive bilateral attachment, according to research published in the March 1 issue of Spine.

Gerald M.Y. Quan, M.D., of Freeman Hospital in Newcastle upon Tyne, U.K., and a colleague studied the outcomes in 49 patients (mean age, 14.4 years) with Lenke I adolescent idiopathic scoliosis who, from 2006 to 2008, underwent posterior corrective surgery and spinal fusion with pedicle screw fixation. The investigators reviewed and compared pre- and postoperative radiographs to determine the degrees of coronal and sagittal correction after surgery and their correlation with the number of implants used per vertebra (implant density).

Overall, the researchers found that the main thoracic curve mean of 60.0 degrees prior to surgery was corrected to a mean 17.4 degrees on the postoperative radiographs, while the preoperative thoracic kyphosis mean of 20.0 degrees was corrected to 11.6 degrees. The investigators found no correlation between implant density and the amount of sagittal or coronal curve correction achieved, regardless of the degree of curve flexibility.

"Pedicle screw constructs provided excellent coronal correction of thoracic idiopathic scoliosis, however, this was at the expense of sagittal contour. Bilateral segmental pedicle screw fixation did not improve curve correction compared with unilateral or alternate segmental fixation," the authors write.

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