ABSTRACT

Due to new morbidity risk, implant removal is not preferred by surgeons until the development of fusion, which takes about 9 to 12 months, un-less implant fails, a similar complication develops or the patient requests. The effect of implant re-moval on clinical outcomes has not been previ-ously investigated. For this purpose, 30 patients with Lenke type I adolescent idiopathic scoliosis (age range: 12-14 at the time of corrective sur-gery) treated with a third generation instrumenta-tion system, experiencing apparent back pain at follow-up examinations and had their implants re-moved upon their request were included in this study. These patients were followed-up for a minimum of two years (mean 42.3 ± 8.2 months) af-ter implant removal. Patients were assigned into two groups based on the timing of implant removal: at the second or third year (Group 1, n=15), and at the fourth year or later (Group 2, n=15). Groups were similar in terms of all preoperative and postoperative parameters (p>0.05). None of the patients had complications like post-operati-ve infections, implant failure, and neurological deficits. Results of early post-operative and final follow-up visits SRS-22 questionnaires are com-pared between groups. Total SRS-22 scores we-re 19.89±1.24 and 21.03±1.22 in Group 1 and 20.28±1.38 and 20.65±1.37 in Group 2, respec-tively (p:0.0). No statistically significant change was observed in terms of self image and mental status domains in either of the groups, however, improvements was detected in terms of pain, function and treatment satisfaction domains. Our findings suggest that in patients with Lenke Type I idiopathic scoliosis, removal of implants before the forth year upon the request of the patient re-duces pain and increases functions, provided the fusion has been developed.