Segmental correction of adolescent idiopathic scoliosis by all-screw fixation method in adolescents and young adults. minimum 5 years follow-up with SF-36 questionnaire

Ching-Hsiao Yu, Po-Quang Chen, Shu-Chuang Ma, Chee-Huan Pan, Ching-Hsiao Yu, Po-Quang Chen, Shu-Chuang Ma, Chee-Huan Pan

Abstract

Background: In our institution, the fixation technique in treating idiopathic scoliosis was shifted from hybrid fixation to the all-screw method beginning in 2000. We conducted this study to assess the intermediate -term outcome of all-screw method in treating adolescent idiopathic scoliosis (AIS).

Methods: Forty-nine consecutive patients were retrospectively included with minimum of 5-year follow-up (mean, 6.1; range, 5.1-7.3 years). The average age of surgery was 18.5 ± 5.0 years. We assessed radiographic measurements at preoperative (Preop), postoperative (PO) and final follow-up (FFU) period. Curve correction rate, correction loss rate, complications, accuracy of pedicle screws and SF-36 scores were analyzed.

Results: The average major curve was corrected from 58.0 ± 13.0° Preop to 16.0 ± 9.0° PO(p < 0.0001), and increased to 18.4 ± 8.6°(p = 0.12) FFU. This revealed a 72.7% correction rate and a correction loss of 2.4° (3.92%). The thoracic kyphosis decreased little at FFU (22 ± 12° to 20 ± 6°, (p = 0.25)). Apical vertebral rotation decreased from 2.1 ± 0.8 PreOP to 0.8 ± 0.8 at FFU (Nash-Moe grading, p < 0.01). Among total 831 pedicle screws, 56 (6.7%) were found to be malpositioned. Compared with 2069 age-matched Taiwanese, SF-36 scores showed inferior result in 2 variables: physical function and role physical.

Conclusion: Follow-up more than 5 years, the authors suggest that all-screw method is an efficient and safe method.

Figures

Figure 1
Figure 1
Comparison of SF-36 scores between 49 AIS patients (black line) and 2069 age-matched Taiwanese (grey line) showed lower scores in PF and RP variables of AIS patients. PF = Physical Function; RP = Role Physical; BP = Bodily Pain; GH = General Health; VT = Vitality scale; SF = Social Function; RE = Role Emotional; MH = Mental Health.
Figure 2
Figure 2
A Preoperative AP, and lateral radiographs of a 13 year-old-female with 1A curve. B, The patient underwent anterior fusion followed by posterior spinal fusion from T3 to L3 with all-screw construct. Postoperative radiographs of 6 years followup showed 55% correction rate.

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