• Eur Spine J · Jun 2013

    Five-year clinical and radiographic outcomes using pedicle screw only constructs in the treatment of adolescent idiopathic scoliosis.

    • Steven W Hwang, Amer F Samdani, Michelle Marks, Tracy Bastrom, Hitesh Garg, Baron Lonner, James T Bennett, Joshua Pahys, Suken Shah, Firoz Miyanji, Harry Shufflebarger, Peter Newton, and Randal Betz.
    • Tufts Medical Center, Floating Hospital for Children, Boston, MA, USA.
    • Eur Spine J. 2013 Jun 1;22(6):1292-9.

    PurposeTo determine the mid-term clinical and radiographic impact of pedicle screw fixation in patients with adolescent idiopathic scoliosis (AIS).MethodsA multicenter AIS database was retrospectively queried to identify 99 consecutive patients who underwent posterior spinal fusion using an all pedicle screw construct with a minimum of 5-year follow-up. Radiographic and clinical parameters were reviewed at regular intervals up to 5 years.ResultsThe mean age was 14.4 ± 2.0 years with 79 % being female. The mean preoperative major curve was 51.7 ± 14.2° with a mean correction of 66 and 64 % at 2 and 5 years (p = 0.16). Pre-op thoracic kyphosis averaged 22.3 ± 12.9° and was 18.4 ± 10.6° at 5 years with no significant change from 2 years (p = 0.33). SRS total and domain scores demonstrated significant improvements at 2 years, which were slightly decreased at 5 years (p = 0.06). SRS scores of self-image (p = 0.99) and satisfaction (p = 0.18) were significantly improved after surgery with minimal change by 5 years. The change in SRS total scores from 2 to 5 years was attributed to differences in SRS scores of pain and mental health (p < 0.05).ConclusionsIntermediate follow-up of patients with AIS treated with an all pedicle screw construct demonstrates maintenance of their coronal, and sagittal plane correction between 2- and 5-year follow-up. At 5 years, improvements in SRS scores were consistent with 2-year values, except for a decline in pain and mental health scores.

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