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Comparative analysis of results of treatment patients with severe spinal deformities using screw and a hybrid hardware
- Authors: Baklanov A.N.1, Kolesov S.V.2, Shavyrin I.A.3
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Affiliations:
- Medical Center of Spine pathology and Neurosurgery
- Priorov Central Institute Of Traumatology and Orthopedics
- Scientific and Practical Center of medical care for children
- Issue: Vol 20, No 1 (2014)
- Pages: 34-43
- Section: Clinical studies
- URL: https://journal.rniito.org/jour/article/view/41
- DOI: https://doi.org/10.21823/2311-2905-2014-0-1-34-43
- ID: 41
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Abstract
Purpose: evaluation of efficacy of operative treatment with the use of screw and hybrid metal constructions in idiopathic scoliosis associated with severe spine deformities. Material and methods: The outcomes of treatment of 34 patients aged 15 to 27 years old with severe scoliosisoperated on using screw metal constructions, were reviewed. 22 patients operated on with the use of hybrid metal constructions, made a control group. The groups were compared by the following parameters: pre- and postoperative Cobb angle, deformity mobility according to traction test, total sagittal/frontal balance, CT apical vertebra rotation, operation time, intraoperative blood loss, the number of instrumented vertebrae, and correction failure at 24-hr spondylograms. Results: Group A (screw spine fixation) demonstrated better outcomes compared to group B (combined spine fixation) in the following parameters. Postoperative correction was 48% and 41%;apical vertebra rotation decreased from 78° to 55° (30%) and from 74° to 59°(21%);total sagittal/frontal balance decreased from 39/25 mmto 14/12 mm (64/52%) and from 35/26 mm to 16/15 mm (55/43%), correspondingly. These results suggest better trunk compensation and postoperative correction in a group of patients with screw fixation. Smaller values of correction failure of the main arc as well as insignificant increase of thoracic kyphosis in the postoperative period (24 months) 3.8%/4.3% in group A compared to 6.2%/7.5% in group B testify to greater reliability and stability of ‘all screw’ metal constructions. The number of fixed elements was on average one more in a group with combined fixation (13 and 14, correspondingly).
About the authors
A. N. Baklanov
Medical Center of Spine pathology and Neurosurgery
Author for correspondence.
Email: bakl10@mail.ru
Russian Federation
S. V. Kolesov
Priorov Central Institute Of Traumatology and Orthopedics
Email: dr-kolesov@ya.ru
Russian Federation
I. A. Shavyrin
Scientific and Practical Center of medical care for children
Email: shailya@yandex.ru
Russian Federation
References
- Васюра А.С., Новиков В.В., Михайловский М.В. и др. Некоторые особенности оперативного лечения тяжелых форм идиопатического сколиоза подростков. Хирургия позвоночника. 2006;(3):29-37
- Кулешов А.А. Тяжелые формы сколиоза. Оперативное лечение и функциональные особенности некоторых органов и систем [дис. ... д-ра мед. наук]. М., 2007
- Aaro S., Dahlbom M. Estimation of vertebral rotation and the spinal and rib cage deformity in scoliosis by computer tomography. Spine. 1981;.6:460-467.
- Brown C.W. Spinal instrumentation techniques. Rosemont, IL: Scoliosis Research Society; 1998.
- De Jonge T., Dubousset J.F., Illes T. Sagittal plane correction in idiopathic scoliosis. Spine. 2002; 27:754-760.
- Kim Y.J., Lenke L.G., Kim J. et al. Comparative analysis of pedicle screw versus hybrid instrumentation in posterior spinal fusion of adolescent idiopathic scoliosis. Spine. 2006;31;291-298.
- Kuklo T.R., Potter B.K., Polly D.W. Jr., Lenke L.G. Monaxial versus multiaxial thoracic pedicle screws in the correction of adolescent idiopathic scoliosis. Spine (Phila Pa 1976). 2005;30(18):2113-2120.
- Lam G.C., Hill D.L., Le L.H. et al. Vertebral rotation measurement: a summary and comparison of common radiographic and CT methods. Scoliosis. 2008;3:16.
- Lee S.M, Suk S.I., Chung E.R. Direct vertebral rotation: a new technique of three-dimensional deformity correction with segmental pedicle screw fixation in adolescent idiopathic scoliosis. Spine, 2004;29(3):343-349.
- Lenke L.G., Betz R., Bridwell K.H. Intraobserver and interobserver reliability of the classification of thoracic adolescent idiopathic scoliosis. J. Bone Joint Surg. 1998;80-A(8):1097-1106.
- Liljenqvist U.R., Halm H.F., Link T.M. Pedicle screw instrumentation of the thoracic spine in idiopathic scoliosis. Spine. 1997; 22:2239-2245.
- Lowe T.G., Betz R.R., Clement D.H. et al. An analysis of anterior versus posterior instrumented fusion for thoracic adolescent idiopathic (AIS) curves 70 - 80 degrees: are there advantages of one over the other? SRS 39th Annual Meeting Scientific: Program and Abstracts. Buenos Aires, 2004. P. 2.
- Lowenstein J.E., Matsumoto H., Vitale M.G. et al. Coronal and sagittal plane correction in adolescent idiopathic scoliosis: a comparison between all pedicle screw versus hybrid thoracic hook lumbar screw constructs. Spine. 2007;32:448-452.
- Luhmann S.J., Lenke L.G., Kim Y.J. et al. Thoracic adolescent idiopathic scoliosis curves between 70 and100 degrees: is anterior release necessary? Spine. 2005;30:2061-2067.
- Suk S.I., Lee S.M., Chung E.R. et al. Determination of distal fusion level with segmental pedicle screw fixation in single thoracic idiopathic scoliosis Spine. 2003;28:484491.
- Suk S.I., Lee C.K., Kim W.J., Chung Y.J., Park Y.B. Segmental pedicle screw fixation in the treatment of thoracic idiopathic scoliosis. Spine. 1995; 20:1399-1405.
- Vora V., Crawford A., Babekhir N. et al. A pedicle screw construct gives an enhanced posterior correction of adolescent idiopathic scoliosis when compared with other constructs: myth or reality. Spine. 2007;32;1869-1874.
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