Alternate Pedicle Screws Technique versus Hybrid Construct for the Correction of Adolescent Idiopathic Scoliosis: A Prospect ive Randomized Study

Background Data: The use of all pedicle screws technique, instead of hybrid constructs,for the treatment of AIS became more popular over the past several years. Studies to compare both techniques were usually retrospectively performed. Purpose: To compare between an alternate all pedicle screws tec...

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Autores principales: Ahmad Fouad, Wael Koptan, Yasser ElMiligui, Mohammad El-Sharkawi
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Lenguaje:EN
Publicado: Egyptian Spine Association 2012
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spelling oai:doaj.org-article:4c67633784924ffdbf8d6fb8cc15355d2021-12-02T04:21:52ZAlternate Pedicle Screws Technique versus Hybrid Construct for the Correction of Adolescent Idiopathic Scoliosis: A Prospect ive Randomized StudyDOI:10.21608/ESJ.2012.37902314-89502314-8969https://doaj.org/article/4c67633784924ffdbf8d6fb8cc15355d2012-07-01T00:00:00Zhttp://esj.journals.ekb.eg/article_3790.htmlhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969Background Data: The use of all pedicle screws technique, instead of hybrid constructs,for the treatment of AIS became more popular over the past several years. Studies to compare both techniques were usually retrospectively performed. Purpose: To compare between an alternate all pedicle screws technique and hybrid constructs in correction of AIS in a prospective trial. Study Design: Prospective, non-randomized. Patients and Methods: The study included 50 patients with adolescent idiopathic scoliosis divided into 2 groups; 27 patients had surgical correction using alternate pedicle screws technique (Group 1) and 23 patients had surgical correction using hybrid constructs (Group 2). The age at surgery had an average of 15y + 7m in Group 1 and 14y + 8m in Group 2. The dorsal curves in Group 1 ranged from 40º to 62º with a mean of 46.5º and in group 2 ranged from 32º to 79º with a mean of 54.3º. The lumbar curves ranged from 14º to 73º with a mean of 41.7º in Group 1 and in Group 2 ranged from 31º to 77º with a mean of 46.8º. The deformity was measured by Cobb’s method preoperatively, postoperatively and at final follow up with measurement of postoperative correction %. Operative time and blood loss were also measured and recorded. All patients had posterior correction, instrumentation and fusion using either an all pedicle screws technique, in an alternating manner, (Group 1); or a hybrid construct including pedicle screws, hooks and sublaminar wires (Group 2). Results: The dorsal curves were corrected in group 1 and group 2 to a mean of 18.2º and 20.9º respectively. The lumbar curves were corrected in group 1 and group 2 to a mean of 14.6º and 17.7º respectively. Patients were followed up for a minimum of 2 years with an average loss of correction of 2.2° and 2.0º respectively. Overall, there was no major postoperative neurological deficit and no metal failure in either group. Conclusion: Correctional power of alternating all screws technique for AIS in the coronal plane was slightly but insignificantly better than hybrid constructs. However, the correction of vertebral rotation was significantly better leading to a lesser need for thoracoplasty with its consequent hazards. (2012ESJ010) Ahmad Fouad Wael KoptanYasser ElMiligui Mohammad El-SharkawiEgyptian Spine Associationarticlescoliosisidiopathicall screwshybridNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 3, Iss 1, Pp 28-34 (2012)
institution DOAJ
collection DOAJ
language EN
topic scoliosis
idiopathic
all screws
hybrid
Neurology. Diseases of the nervous system
RC346-429
spellingShingle scoliosis
idiopathic
all screws
hybrid
Neurology. Diseases of the nervous system
RC346-429
Ahmad Fouad
Wael Koptan
Yasser ElMiligui
Mohammad El-Sharkawi
Alternate Pedicle Screws Technique versus Hybrid Construct for the Correction of Adolescent Idiopathic Scoliosis: A Prospect ive Randomized Study
description Background Data: The use of all pedicle screws technique, instead of hybrid constructs,for the treatment of AIS became more popular over the past several years. Studies to compare both techniques were usually retrospectively performed. Purpose: To compare between an alternate all pedicle screws technique and hybrid constructs in correction of AIS in a prospective trial. Study Design: Prospective, non-randomized. Patients and Methods: The study included 50 patients with adolescent idiopathic scoliosis divided into 2 groups; 27 patients had surgical correction using alternate pedicle screws technique (Group 1) and 23 patients had surgical correction using hybrid constructs (Group 2). The age at surgery had an average of 15y + 7m in Group 1 and 14y + 8m in Group 2. The dorsal curves in Group 1 ranged from 40º to 62º with a mean of 46.5º and in group 2 ranged from 32º to 79º with a mean of 54.3º. The lumbar curves ranged from 14º to 73º with a mean of 41.7º in Group 1 and in Group 2 ranged from 31º to 77º with a mean of 46.8º. The deformity was measured by Cobb’s method preoperatively, postoperatively and at final follow up with measurement of postoperative correction %. Operative time and blood loss were also measured and recorded. All patients had posterior correction, instrumentation and fusion using either an all pedicle screws technique, in an alternating manner, (Group 1); or a hybrid construct including pedicle screws, hooks and sublaminar wires (Group 2). Results: The dorsal curves were corrected in group 1 and group 2 to a mean of 18.2º and 20.9º respectively. The lumbar curves were corrected in group 1 and group 2 to a mean of 14.6º and 17.7º respectively. Patients were followed up for a minimum of 2 years with an average loss of correction of 2.2° and 2.0º respectively. Overall, there was no major postoperative neurological deficit and no metal failure in either group. Conclusion: Correctional power of alternating all screws technique for AIS in the coronal plane was slightly but insignificantly better than hybrid constructs. However, the correction of vertebral rotation was significantly better leading to a lesser need for thoracoplasty with its consequent hazards. (2012ESJ010)
format article
author Ahmad Fouad
Wael Koptan
Yasser ElMiligui
Mohammad El-Sharkawi
author_facet Ahmad Fouad
Wael Koptan
Yasser ElMiligui
Mohammad El-Sharkawi
author_sort Ahmad Fouad
title Alternate Pedicle Screws Technique versus Hybrid Construct for the Correction of Adolescent Idiopathic Scoliosis: A Prospect ive Randomized Study
title_short Alternate Pedicle Screws Technique versus Hybrid Construct for the Correction of Adolescent Idiopathic Scoliosis: A Prospect ive Randomized Study
title_full Alternate Pedicle Screws Technique versus Hybrid Construct for the Correction of Adolescent Idiopathic Scoliosis: A Prospect ive Randomized Study
title_fullStr Alternate Pedicle Screws Technique versus Hybrid Construct for the Correction of Adolescent Idiopathic Scoliosis: A Prospect ive Randomized Study
title_full_unstemmed Alternate Pedicle Screws Technique versus Hybrid Construct for the Correction of Adolescent Idiopathic Scoliosis: A Prospect ive Randomized Study
title_sort alternate pedicle screws technique versus hybrid construct for the correction of adolescent idiopathic scoliosis: a prospect ive randomized study
publisher Egyptian Spine Association
publishDate 2012
url https://doaj.org/article/4c67633784924ffdbf8d6fb8cc15355d
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