ABSTRACT

Segmental pedicle screw fixation has been proven to enable true segmental control and greater correction both in coronal and sagittal planes of scoliosis. The purpose of this study was to evaluate adolescent idiopathic scoliosis (AIS) patients undergoing a posterior spinal fusion with a all-pedicle screw construct in term of radiolographic outcome.

A total 12 patients with AIS at a single institution who underwent a posterior spinal fusion with segmental pedicle screw instrumentation were evaluated. Standing anteroposterior and lateral preoperative radiographs, and anteroposterior and lateral postoperative radiographs were evaluated for curve magnitude and postoperative correction to assess the efficacy of these constructs in the immediate postoperative period and at latest follow-up.

Mean patient age at the time of operation was 15.2 (range 13-17 years) and average follow-up period was 12.0 ± 8.09 months. The most frequent curve pattern was Lenke type 1 (7 cases), followed by type 5 (3 cases) and type 3 (2 cases). The average major curve measured 48.0° ± 8.6° preoperatively corrected to 10.0° ± 6.4° at final follow - up and this was statistically significant (p<0.0001) . Sagittal thoracic aligment (T4-T12), increased from 25.7° ± 5.5° to 26.09° ± 7.3° at final follow-up (p=0.9). Lomber lordosis (L1-L5) was changed from 40.4° ± 10.5° to 41.4° ± 5.9° (p=0.79) and thoracolumbar junctional kyphosis (T10-L2) increased from 8.1° ± 4.7° to 9.0° ± 5.9° at final follow-up (p=0.73). There were no neurologic or visceral complications related to pedicle screw instrumentation.

In conclusion acceptable radiographic outcome can be achieved with posterior-only deformity correction for the treatment of AIS with pedicle screws.