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Erschienen in: European Spine Journal 7/2015

01.07.2015 | Original Article

Skipped versus consecutive pedicle screw constructs for correction of Lenke 1 curves

verfasst von: Simon Morr, Alexandra Carrer, Luis Ignacio Alvarez-García de Quesada, Juan Carlos Rodriguez-Olaverri

Erschienen in: European Spine Journal | Ausgabe 7/2015

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Abstract

Purpose

Thoracic pedicle screws provide superior curve correction to hook and wire constructs in adolescent idiopathic scoliosis, while increasing cost. The number of implants required for best correction and outcome has not yet been determined.

Methods

We retrospectively reviewed pre- and post-operative radiographs and self-reported outcome measures in an age- and curve-matched cohort of 40 patients with Lenke I AIS who underwent selective fusions between T3/4 and L1. Twenty patients were treated with thoracic pedicle screws at every level bilaterally (CON) and 20 patients with screws at every level on the concave side and skipped levels on the convex side of the curve (SKP). All patients had a minimum 2-year follow-up. Radiographs were assessed for coronal and sagittal curvatures, as well as thoracic torsion and vertebral rotation. Health-related quality of life was assessed using the SRS-22 instrument. Instrumentation cost data were collected for each case.

Results

Postoperative follow-up averaged 28 months for the CON group and 29 months for the SKP group. No statistically significant differences were found between groups with respect to age and pre- and post-operative radiographic parameters. Both constructs provided acceptable correction of the main thoracic curves (66.9 vs. 66.6 %, CON group and SKP group, respectively; p = 0.92), and spontaneous correction of the proximal thoracic (41.5 vs. 41.1 %; p = 0.92) and thoracolumbar/lumbar curves (54.8 vs. 54.3 %; p = 0.92). No significant difference was found in postoperative SRS-22 scores (96 vs. 94.3; p = 0.34). The CON group cost for instrumentation was significantly higher than the SKP group ($19,500 vs. $13,300; p = 0.002). There was no statistically significant difference in operating room times between groups.

Conclusion

Both construct types provide excellent coronal correction and sagittal balance, with no significant differences in radiographic findings or clinical outcomes. A significant decrease in cost was found with use of skipped screw constructs.
Literatur
1.
Zurück zum Zitat Lenke LG, Betz RR, Clements D, Merola A, Haher T, Lowe T, Bridwell KH, Blanke K (2002) Curve prevalence of a new classification of operative adolescent idiopathic scoliosis: does classification correlate with treatment? Spine (Phila Pa 1976) 27(6):604–611CrossRef Lenke LG, Betz RR, Clements D, Merola A, Haher T, Lowe T, Bridwell KH, Blanke K (2002) Curve prevalence of a new classification of operative adolescent idiopathic scoliosis: does classification correlate with treatment? Spine (Phila Pa 1976) 27(6):604–611CrossRef
2.
Zurück zum Zitat Cuartas E, Rasouli A, O’Brien M, Shufflebarger HL (2009) Use of all-pedicle-screw constructs in the treatment of adolescent idiopathic scoliosis. J Am Acad Orthop Surg 17(9):550–561PubMed Cuartas E, Rasouli A, O’Brien M, Shufflebarger HL (2009) Use of all-pedicle-screw constructs in the treatment of adolescent idiopathic scoliosis. J Am Acad Orthop Surg 17(9):550–561PubMed
3.
Zurück zum Zitat Vaccaro AR, Rizzolo SJ, Allardyce TJ, Ramsey M, Salvo J, Balderston RA, Cotler JM (1995) Placement of pedicle screws in the thoracic spine. Part I: morphometric analysis of the thoracic vertebrae. J Bone Joint Surg Am 77(8):1193–1199PubMed Vaccaro AR, Rizzolo SJ, Allardyce TJ, Ramsey M, Salvo J, Balderston RA, Cotler JM (1995) Placement of pedicle screws in the thoracic spine. Part I: morphometric analysis of the thoracic vertebrae. J Bone Joint Surg Am 77(8):1193–1199PubMed
4.
Zurück zum Zitat Vaccaro AR, Rizzolo SJ, Balderston RA, Allardyce TJ, Garfin SR, Dolinskas C, An HS (1995) Placement of pedicle screws in the thoracic spine. Part II: an anatomical and radiographic assessment. J Bone Joint Surg Am 77(8):1200–1206PubMed Vaccaro AR, Rizzolo SJ, Balderston RA, Allardyce TJ, Garfin SR, Dolinskas C, An HS (1995) Placement of pedicle screws in the thoracic spine. Part II: an anatomical and radiographic assessment. J Bone Joint Surg Am 77(8):1200–1206PubMed
5.
Zurück zum Zitat Lonstein JE, Denis F, Perra JH, Pinto MR, Smith MD, Winter RB (1999) Complications associated with pedicle screws. J Bone Joint Surg Am 81:1519–1528PubMed Lonstein JE, Denis F, Perra JH, Pinto MR, Smith MD, Winter RB (1999) Complications associated with pedicle screws. J Bone Joint Surg Am 81:1519–1528PubMed
6.
Zurück zum Zitat Belmont PJ, Klemme WR, Dhawan A, Polly DW Jr (2001) In vivo accuracy of thoracic pedicle screws. Spine (Phila Pa 1976) 26:2340–2346CrossRef Belmont PJ, Klemme WR, Dhawan A, Polly DW Jr (2001) In vivo accuracy of thoracic pedicle screws. Spine (Phila Pa 1976) 26:2340–2346CrossRef
7.
Zurück zum Zitat Belmont PJ, Klemme WR, Robinson M, Polly DW Jr (2002) Accuracy of thoracic pedicle screws in patients with and without coronal-plane spinal deformities. Spine (Phila Pa 1976) 27:1558–1566CrossRef Belmont PJ, Klemme WR, Robinson M, Polly DW Jr (2002) Accuracy of thoracic pedicle screws in patients with and without coronal-plane spinal deformities. Spine (Phila Pa 1976) 27:1558–1566CrossRef
8.
Zurück zum Zitat Carbone JJ, Tortolani J, Quartararo LG (2003) Fluoroscopically assisted pedicle screw fixation for thoracic and thoracolumbar injuries: technique and shortterm complications. Spine (Phila Pa 1976) 28:91–97CrossRef Carbone JJ, Tortolani J, Quartararo LG (2003) Fluoroscopically assisted pedicle screw fixation for thoracic and thoracolumbar injuries: technique and shortterm complications. Spine (Phila Pa 1976) 28:91–97CrossRef
9.
Zurück zum Zitat Kim YJ, Lenke LG, Bridwell KH, Cho YS, Riew KD (2004) Free hand pedicle screw placement in the thoracic spine: is it safe? Spine (Phila Pa 1976) 29:333–342CrossRef Kim YJ, Lenke LG, Bridwell KH, Cho YS, Riew KD (2004) Free hand pedicle screw placement in the thoracic spine: is it safe? Spine (Phila Pa 1976) 29:333–342CrossRef
10.
Zurück zum Zitat Liljenqvist UR, Halm HFH, Link TM (1997) Pedicle screw instrumentation of the thoracic spine in idiopathic scoliosis. Spine (Phila Pa 1976) 22:2239–2245CrossRef Liljenqvist UR, Halm HFH, Link TM (1997) Pedicle screw instrumentation of the thoracic spine in idiopathic scoliosis. Spine (Phila Pa 1976) 22:2239–2245CrossRef
11.
Zurück zum Zitat Liljenquvist UR, Lesien U, Hackenberg L, Niemeyer T, Halm H (2002) Comparative analysis of pedicle screw and hook instrumentation in posterior correction and fusion of idiopathic thoracic scoliosis. Eur Spine J 11:336–343CrossRef Liljenquvist UR, Lesien U, Hackenberg L, Niemeyer T, Halm H (2002) Comparative analysis of pedicle screw and hook instrumentation in posterior correction and fusion of idiopathic thoracic scoliosis. Eur Spine J 11:336–343CrossRef
12.
Zurück zum Zitat Suk SI, Lee CK, Kim WJ, Chung YJ, Park YB (1995) Segmental pedicle screw fixation in the treatment of thoracic idiopathic scoliosis. Spine (Phila Pa 1976) 20:1399–1405CrossRef Suk SI, Lee CK, Kim WJ, Chung YJ, Park YB (1995) Segmental pedicle screw fixation in the treatment of thoracic idiopathic scoliosis. Spine (Phila Pa 1976) 20:1399–1405CrossRef
13.
Zurück zum Zitat Suk SI, Kim WJ, Kim JH, Lee SM (1999) Restoration of thoracic kyphosis in the hypokyphotic spine: a comparison between multiple-hook and segmental pedicle screw fixation in adolescent idiopathic scoliosis. J Spinal Disord 12:489–495PubMedCrossRef Suk SI, Kim WJ, Kim JH, Lee SM (1999) Restoration of thoracic kyphosis in the hypokyphotic spine: a comparison between multiple-hook and segmental pedicle screw fixation in adolescent idiopathic scoliosis. J Spinal Disord 12:489–495PubMedCrossRef
14.
Zurück zum Zitat Suk S, Kim WJ, Lee SM, Kim JH, Chung ER (2001) Thoracic pedicle screw fixation in spinal deformities: are they really safe? Spine (Phila Pa 1976) 26:2049–2057CrossRef Suk S, Kim WJ, Lee SM, Kim JH, Chung ER (2001) Thoracic pedicle screw fixation in spinal deformities: are they really safe? Spine (Phila Pa 1976) 26:2049–2057CrossRef
15.
Zurück zum Zitat Suk SI, Lee SM, Chung ER, Kim JH, Kim WJ, Sohn HM (2003) Determination of distal fusion level with segmental pedicle screw fixation in single thoracic idiopathic scoliosis. Spine (Phila Pa 1976) 28:484–491 Suk SI, Lee SM, Chung ER, Kim JH, Kim WJ, Sohn HM (2003) Determination of distal fusion level with segmental pedicle screw fixation in single thoracic idiopathic scoliosis. Spine (Phila Pa 1976) 28:484–491
16.
Zurück zum Zitat Abul-Kasim K, Ohlin A (2012) Patients with adolescent idiopathic scoliosis of Lenke type-1 curve exhibit specific pedicle width pattern. Eur Spine J 21(1):57–63PubMedCentralPubMedCrossRef Abul-Kasim K, Ohlin A (2012) Patients with adolescent idiopathic scoliosis of Lenke type-1 curve exhibit specific pedicle width pattern. Eur Spine J 21(1):57–63PubMedCentralPubMedCrossRef
17.
Zurück zum Zitat Hwang SW, Samdani AF, Marks M, Bastrom T, Garg H, Lonner B, Bennett JT, Pahys J, Shah S, Miyanji F, Shufflebarger H, Newton P, Betz R (2013) Five-year clinical and radiographic outcomes using pedicle screw only constructs in the treatment of adolescent idiopathic scoliosis. Eur Spine J 22(6):1292–1299PubMedCentralPubMedCrossRef Hwang SW, Samdani AF, Marks M, Bastrom T, Garg H, Lonner B, Bennett JT, Pahys J, Shah S, Miyanji F, Shufflebarger H, Newton P, Betz R (2013) Five-year clinical and radiographic outcomes using pedicle screw only constructs in the treatment of adolescent idiopathic scoliosis. Eur Spine J 22(6):1292–1299PubMedCentralPubMedCrossRef
18.
Zurück zum Zitat Lonstein JE (2006) Scoliosis: surgical versus nonsurgical treatment. Clin Orthop Relat Res 443:248–259PubMedCrossRef Lonstein JE (2006) Scoliosis: surgical versus nonsurgical treatment. Clin Orthop Relat Res 443:248–259PubMedCrossRef
19.
Zurück zum Zitat Kuklo TR, Potter BK, Polly DW, Lenke LG (2005) Monaxial versus multiaxial thoracic pedicle screws in the correction of adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 30(18):2113–2120CrossRef Kuklo TR, Potter BK, Polly DW, Lenke LG (2005) Monaxial versus multiaxial thoracic pedicle screws in the correction of adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 30(18):2113–2120CrossRef
20.
Zurück zum Zitat Kim YJ, Lenke LG, Cho SK, Bridwell KH, Sides B, Blanke K (2004) Comparative analysis of pedicle screw versus hook instrumentation in posterior spinal fusion of adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 29:2040–2048CrossRef Kim YJ, Lenke LG, Cho SK, Bridwell KH, Sides B, Blanke K (2004) Comparative analysis of pedicle screw versus hook instrumentation in posterior spinal fusion of adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 29:2040–2048CrossRef
21.
Zurück zum Zitat Min K, Sdzuy C, Farshad M (2013) Posterior correction of thoracic adolescent idiopathic scoliosis with pedicle screw instrumentation: results of 48 patients with minimal 10-year follow-up. Eur Spine J 22(2):345–354PubMedCentralPubMedCrossRef Min K, Sdzuy C, Farshad M (2013) Posterior correction of thoracic adolescent idiopathic scoliosis with pedicle screw instrumentation: results of 48 patients with minimal 10-year follow-up. Eur Spine J 22(2):345–354PubMedCentralPubMedCrossRef
22.
Zurück zum Zitat Li J, Cheung KM, Samartzis D, Ganal-Antonio AK, Zhu X, Li M, Luk KD (2014) Key vertebral screws strategy for main thoracic curve correction in patients with adolescent idiopathic scoliosis. J Spinal Disord Tech [Epub ahead of print] Li J, Cheung KM, Samartzis D, Ganal-Antonio AK, Zhu X, Li M, Luk KD (2014) Key vertebral screws strategy for main thoracic curve correction in patients with adolescent idiopathic scoliosis. J Spinal Disord Tech [Epub ahead of print]
23.
Zurück zum Zitat Quan GM, Gibson MJ (2010) Correction of main thoracic adolescent idiopathic scoliosis using pedicle screw instrumentation: does higher implant density improve correction? Spine (Phila Pa 1976) 35(5):562–567CrossRef Quan GM, Gibson MJ (2010) Correction of main thoracic adolescent idiopathic scoliosis using pedicle screw instrumentation: does higher implant density improve correction? Spine (Phila Pa 1976) 35(5):562–567CrossRef
24.
Zurück zum Zitat Li M, Shen Y, Fang X, Ni J, Gu S, Zhu X, Zhang Z (2009) Coronal and sagittal plane correction in patients with Lenke 1 adolescent idiopathic scoliosis: a comparison of consecutive versus interval pedicle screw placement. J Spinal Disord Tech 22(4):251–256PubMedCrossRef Li M, Shen Y, Fang X, Ni J, Gu S, Zhu X, Zhang Z (2009) Coronal and sagittal plane correction in patients with Lenke 1 adolescent idiopathic scoliosis: a comparison of consecutive versus interval pedicle screw placement. J Spinal Disord Tech 22(4):251–256PubMedCrossRef
25.
Zurück zum Zitat Kuklo TR, Potter BK, Lenke LG (2005) Vertebral rotation and thoracic torsion in adolescent idiopathic scoliosis: what is the best radiographic correlate? J Spinal Disord Tech 18(2):139–147PubMedCrossRef Kuklo TR, Potter BK, Lenke LG (2005) Vertebral rotation and thoracic torsion in adolescent idiopathic scoliosis: what is the best radiographic correlate? J Spinal Disord Tech 18(2):139–147PubMedCrossRef
26.
Zurück zum Zitat Berven S, Deviren V, Demir-Deviren S, Hu SS, Bradford DS (2003) Studies in the modified Scoliosis Research Society Outcomes Instrument in adults: validation, reliability, and discriminatory capacity. Spine (Phila Pa 1976) 28(18):2164–2169CrossRef Berven S, Deviren V, Demir-Deviren S, Hu SS, Bradford DS (2003) Studies in the modified Scoliosis Research Society Outcomes Instrument in adults: validation, reliability, and discriminatory capacity. Spine (Phila Pa 1976) 28(18):2164–2169CrossRef
27.
Zurück zum Zitat Suk SI, Lee SM, Chung ER, Kim JH, Kim SS (2005) Selective thoracic fusion with segmental pedicle screw fixation in the treatment of thoracic idiopathic scoliosis: more than 5-year follow-up. Spine (Phila Pa 1976) 30(14):1602–1609CrossRef Suk SI, Lee SM, Chung ER, Kim JH, Kim SS (2005) Selective thoracic fusion with segmental pedicle screw fixation in the treatment of thoracic idiopathic scoliosis: more than 5-year follow-up. Spine (Phila Pa 1976) 30(14):1602–1609CrossRef
28.
Zurück zum Zitat Potter BK, Kuklo TR, Lenke LG (2005) Radiographic outcomes of anterior spinal fusion versus posterior spinal fusion with thoracic pedicle screws for treatment of Lenke type I adolescent idiopathic scoliosis curves. Spine (Phila Pa 1976) 30(16):1859–1866CrossRef Potter BK, Kuklo TR, Lenke LG (2005) Radiographic outcomes of anterior spinal fusion versus posterior spinal fusion with thoracic pedicle screws for treatment of Lenke type I adolescent idiopathic scoliosis curves. Spine (Phila Pa 1976) 30(16):1859–1866CrossRef
29.
Zurück zum Zitat Gebhart S, Alton TB, Bompadre V, Krengel WF (2014) Do anchor density or pedicle screw density correlate with short-term outcome measures in adolescent idiopathic scoliosis surgery? Spine (Phila Pa 1976) 39(2):E104–E110CrossRef Gebhart S, Alton TB, Bompadre V, Krengel WF (2014) Do anchor density or pedicle screw density correlate with short-term outcome measures in adolescent idiopathic scoliosis surgery? Spine (Phila Pa 1976) 39(2):E104–E110CrossRef
30.
Zurück zum Zitat Bharucha NJ, Lonner BS, Auerbach JD, Kean KE, Trobisch PD (2013) Low-density versus high-density thoracic pedicle screw constructs in adolescent idiopathic scoliosis: do more screws lead to a better outcome? Spine J 13(4):375–381PubMedCrossRef Bharucha NJ, Lonner BS, Auerbach JD, Kean KE, Trobisch PD (2013) Low-density versus high-density thoracic pedicle screw constructs in adolescent idiopathic scoliosis: do more screws lead to a better outcome? Spine J 13(4):375–381PubMedCrossRef
31.
Zurück zum Zitat Yang S, Jones-Quaidoo SM, Eager M, Griffin JW, Reddi V, Novicoff W, Shilt J, Bersusky E, Defino H, Ouellet J, Arlet V (2011) Right adolescent idiopathic thoracic curve (Lenke 1 A and B): does cost of instrumentation and implant density improve radiographic and cosmetic parameters? Eur Spine J 20(7):1039–1047PubMedCentralPubMedCrossRef Yang S, Jones-Quaidoo SM, Eager M, Griffin JW, Reddi V, Novicoff W, Shilt J, Bersusky E, Defino H, Ouellet J, Arlet V (2011) Right adolescent idiopathic thoracic curve (Lenke 1 A and B): does cost of instrumentation and implant density improve radiographic and cosmetic parameters? Eur Spine J 20(7):1039–1047PubMedCentralPubMedCrossRef
32.
Zurück zum Zitat Wang X, Aubin CE, Robitaille I, Labelle H (2012) Biomechanical comparison of alternative densities of pedicle screws for the treatment of adolescent idiopathic scoliosis. Eur Spine J 21(6):1082–1090PubMedCentralPubMedCrossRef Wang X, Aubin CE, Robitaille I, Labelle H (2012) Biomechanical comparison of alternative densities of pedicle screws for the treatment of adolescent idiopathic scoliosis. Eur Spine J 21(6):1082–1090PubMedCentralPubMedCrossRef
33.
Zurück zum Zitat Elfiky TA, Samartzis D, Cheung WY, Wong YW, Luk KD, Cheung KM (2011) The proximal thoracic curve in adolescent idiopathic scoliosis: surgical strategy and management outcomes. Global Spine J 1(1):27–36PubMedCentralPubMedCrossRef Elfiky TA, Samartzis D, Cheung WY, Wong YW, Luk KD, Cheung KM (2011) The proximal thoracic curve in adolescent idiopathic scoliosis: surgical strategy and management outcomes. Global Spine J 1(1):27–36PubMedCentralPubMedCrossRef
34.
Zurück zum Zitat Arlet V, Ouellet JA, Shilt J, Shen FH, Wood K, Chan D, Hicks J, Bersusky E, Reddi V (2009) Subjective evaluation of treatment outcomes of instrumentation with pedicle screws or hybrid constructs in Lenke type 1 and 2 adolescent idiopathic scoliosis: what happens when judges are blinded to the instrumentation? Eur Spine J 18(12):1927–1935PubMedCentralPubMedCrossRef Arlet V, Ouellet JA, Shilt J, Shen FH, Wood K, Chan D, Hicks J, Bersusky E, Reddi V (2009) Subjective evaluation of treatment outcomes of instrumentation with pedicle screws or hybrid constructs in Lenke type 1 and 2 adolescent idiopathic scoliosis: what happens when judges are blinded to the instrumentation? Eur Spine J 18(12):1927–1935PubMedCentralPubMedCrossRef
35.
Zurück zum Zitat Dobbs MB, Lenke LG, Kim YJ, Luhmann SJ, Bridwell KH (2006) Anterior/posterior spinal instrumentation versus posterior instrumentation alone for the treatment of adolescent idiopathic scoliotic curves more than 90 degrees. Spine (Phila Pa 1976) 31(20):2386–2391CrossRef Dobbs MB, Lenke LG, Kim YJ, Luhmann SJ, Bridwell KH (2006) Anterior/posterior spinal instrumentation versus posterior instrumentation alone for the treatment of adolescent idiopathic scoliotic curves more than 90 degrees. Spine (Phila Pa 1976) 31(20):2386–2391CrossRef
36.
Zurück zum Zitat Luhmann SJ, Lenke LG, Kim YJ, Bridwell KH, Schootman M (2005) Thoracic adolescent idiopathic scoliosis curves between 70 degrees and 100 degrees: is anterior release necessary? Spine (Phila Pa 1976) 30(18):2061–2067CrossRef Luhmann SJ, Lenke LG, Kim YJ, Bridwell KH, Schootman M (2005) Thoracic adolescent idiopathic scoliosis curves between 70 degrees and 100 degrees: is anterior release necessary? Spine (Phila Pa 1976) 30(18):2061–2067CrossRef
37.
Zurück zum Zitat Chen J, Yang C, Ran B, Wang Y, Wang C, Zhu X, Bai Y, Li M (2013) Correction of Lenke 5 adolescent idiopathic scoliosis using pedicle screw instrumentation: does implant density influence the correction? Spine (Phila Pa 1976) 38(15):946–951CrossRef Chen J, Yang C, Ran B, Wang Y, Wang C, Zhu X, Bai Y, Li M (2013) Correction of Lenke 5 adolescent idiopathic scoliosis using pedicle screw instrumentation: does implant density influence the correction? Spine (Phila Pa 1976) 38(15):946–951CrossRef
38.
Zurück zum Zitat Clements DH, Betz RR, Newton PO, Rohmiller M, Marks MC, Bastrom T (2009) Correlation of scoliosis curve correction with the number and type of fixation anchors. Spine (Phila Pa 1976) 34(20):2147–2150CrossRef Clements DH, Betz RR, Newton PO, Rohmiller M, Marks MC, Bastrom T (2009) Correlation of scoliosis curve correction with the number and type of fixation anchors. Spine (Phila Pa 1976) 34(20):2147–2150CrossRef
Metadaten
Titel
Skipped versus consecutive pedicle screw constructs for correction of Lenke 1 curves
verfasst von
Simon Morr
Alexandra Carrer
Luis Ignacio Alvarez-García de Quesada
Juan Carlos Rodriguez-Olaverri
Publikationsdatum
01.07.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
European Spine Journal / Ausgabe 7/2015
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-015-3769-5

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