Original Article

COMPARATIVE ANALYSIS OF PEDICLE SCREW VERSUS HYBRID INSTRUMENTATION IN POSTERIOR SPINAL CORRECTION AND FUSION OF ADOLESCENT IDIOPATHIC SCOLIOSIS

  • Onat ÜZÜMCÜGİL
  • Yunus ATICI
  • Kaddafi DUYMUŞ
  • Erhan ŞÜKÜR
  • Merter YALÇINKAYA
  • Murat MERT
  • Mustafa CANİKLİOĞLU

J Turk Spinal Surg 2010;21(1):29-38

The aim of this study was to compare the results of pedicle screw versus hybrid instrumentation in posterior spinal correction and fusion of adolescent idiopathic scoliosis. For this purpose 19 females having adolescent idiopathic scoliosis that underwent posterior spinal fusion in our institute were included in this retrospective comparative study. 11 of 19 patients who were treated with posterior spinal fusion via pedicle screws formed Group I where the remaining 8 patients who were fused posterior via hybrid instrumentation formed Group II. The mean age at the operation time in Group I was 12 (range 10-13). The mean age in Group II was 12.5 (range 11-13). The average follow-up period was 43 months (range 22-71 months) in group I and 54.6 months (range 23-71 months) in Group II. All of the cases were classified according to the Lenke Classification System for idiopathic scoliosis preoperatively. At the preoperative, postoperative and last follow-up period the magnitudes of the curves in thoracic and lumbar regions were measured according to the Cobb method. Deviation in the sagittal plane, thoracic kyphosis and lumbar lordosis were also noted. The loss of blood during the procedures, pulmonary function tests and complications in the postoperative period were also evaluated. At the end the retrospective data of two groups underwent statistical analysis. There was not a significant difference between the parameters of both groups in terms of age, follow-up period, respiratory function tests, curve correction and correction durability, complications, thoracic kyphosis, and lumbar lordosis. The blood loss during the procedure in Group I was significantly higher than Group II (p<0.02). Additionally, even it was not significant according to the statistical analysis, the durability of lumbar curve correction in Group II deteriorated much more than Group I during the follow-up period which should be considered to be of value clinically. As a conclusion, both pedicle screw and hybrid posterior instrumentation in the surgical treatment of adolescent idiopathic scoliosis are valid and safe methods displaying similar clinical and radiographic results, but hybrid instrumentation causes significantly less bleeding during the procedure when compared with pedicle screw instrumentation respectively.

Keywords: Retrospective comparative clinical trial, Level III