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Teens Prefer Pedicle Screw Result Over Hybrid Construct

Better appearance using pedicle screws for scoliosis surgery; cost-effective analysis needed

MONDAY, Feb. 14 (HealthDay News) -- Adolescent patients undergoing surgery for scoliosis report improved postoperative appearance when all pedicle screws are used versus less costly hybrid constructs, according to a study published in the Feb. 1 issue of Spine.

Mia Smucny, of the University of California in San Francisco, and colleagues measured self-assessment of appearance in 154 adolescents who underwent posterior spinal fusion with instrumentation for adolescent idiopathic scoliosis with either all pedicle screws or hybrid constructs. The Spinal Appearance Questionnaire (SAQ) and the Scoliosis Research Society outcomes instrument (SRS-30) were used before and after surgery to assess outcome by implant type.

The researchers found that, with the pedicle-screw surgical technique, patients achieved significantly better results on the questionnaires. Although both implant groups improved over time, the pedicle-screw group had more improvement in shoulder level, had better scores in the category "looking better in clothes" two years after surgery, and scored higher in the Appearance and Mental domains of the SRS-30 compared to the hybrid-construct group.

"The clinical significance of these differences is not known and awaits establishment of the minimal clinically important differences for the adolescent SAQ and SRS-30. Once clinical significance has been established, a rigorous cost-effective analysis can be done to determine if the improvement seen with all pedicle screw constructs justifies their additional cost over hybrid constructs," the authors write.

The authors disclosed financial support for the study from Medtronic.

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