Journal of neurosurgery. Pediatrics
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J Neurosurg Pediatr · Apr 2017
ReviewDoes higher screw density improve radiographic and clinical outcomes in adolescent idiopathic scoliosis? A systematic review and pooled analysis.
OBJECTIVE The radiographic and clinical outcomes of low-density (LD) versus high-density (HD) screw constructs in patients with adolescent idiopathic scoliosis (AIS) treated with all-pedicle screw constructs are still controversial. A systematic review and pooled analysis were performed to compare radiographic, perioperative, and quality-of-life (QOL) outcomes and complications in patients with moderate AIS treated with LD or HD screw constructs. METHODS The MEDLINE, Embase, and Web of Science databases were searched for English-language articles addressing LD versus HD screw constructs in AIS patients treated with all-pedicle screw constructs. ⋯ Reduced operative time (mean difference -48.56 minutes, 95% CI -82.69 to -14.43 minutes, p = 0.005, I2 = 87%), blood loss (mean difference -77.85 ml, 95% CI -153.10 to -2.60 ml, p = 0.04, I2 = 0%), and hospital charges (mean difference -$5.92K, 95% CI -$6.59K to -$5.26K, p < 0.00001, I2 = 0%) were found in the LD group, compared with the HD group. CONCLUSIONS LD and HD screw constructs are both associated with satisfactory radiographic and QOL outcomes with few complications. This study supports the use of LD screw constructs for the treatment of moderate AIS, because they resulted in reduced operative time, blood loss, and hospital charges while maintaining radiographic and QOL outcomes and complication rates similar to those achieved with HD screw constructs.
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J Neurosurg Pediatr · Apr 2017
ReviewDoes higher screw density improve radiographic and clinical outcomes in adolescent idiopathic scoliosis? A systematic review and pooled analysis.
OBJECTIVE The radiographic and clinical outcomes of low-density (LD) versus high-density (HD) screw constructs in patients with adolescent idiopathic scoliosis (AIS) treated with all-pedicle screw constructs are still controversial. A systematic review and pooled analysis were performed to compare radiographic, perioperative, and quality-of-life (QOL) outcomes and complications in patients with moderate AIS treated with LD or HD screw constructs. METHODS The MEDLINE, Embase, and Web of Science databases were searched for English-language articles addressing LD versus HD screw constructs in AIS patients treated with all-pedicle screw constructs. ⋯ Reduced operative time (mean difference -48.56 minutes, 95% CI -82.69 to -14.43 minutes, p = 0.005, I2 = 87%), blood loss (mean difference -77.85 ml, 95% CI -153.10 to -2.60 ml, p = 0.04, I2 = 0%), and hospital charges (mean difference -$5.92K, 95% CI -$6.59K to -$5.26K, p < 0.00001, I2 = 0%) were found in the LD group, compared with the HD group. CONCLUSIONS LD and HD screw constructs are both associated with satisfactory radiographic and QOL outcomes with few complications. This study supports the use of LD screw constructs for the treatment of moderate AIS, because they resulted in reduced operative time, blood loss, and hospital charges while maintaining radiographic and QOL outcomes and complication rates similar to those achieved with HD screw constructs.