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Open Access Highly Accessed Research

Segmental correction of adolescent idiopathic scoliosis by all-screw fixation method in adolescents and young adults. minimum 5 years follow-up with SF-36 questionnaire

Ching-Hsiao Yu1, Po-Quang Chen2*, Shu-Chuang Ma2 and Chee-Huan Pan2

Author Affiliations

1 Department of Orthopaedic Surgery, Tao-Yuan General Hospital, No.1492, Zhongshan Rd, Taoyuan City 330, Taiwan, (R.O.C

2 Department of Orthopaedic Surgery, National Taiwan University Hospital, No. 7. Chung San South Road, Taipei 100, Taiwan

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Scoliosis 2012, 7:5  doi:10.1186/1748-7161-7-5

Published: 19 February 2012

Abstract

Background

In our institution, the fixation technique in treating idiopathic scoliosis was shifted from hybrid fixation to the all-screw method beginning in 2000. We conducted this study to assess the intermediate -term outcome of all-screw method in treating adolescent idiopathic scoliosis (AIS).

Methods

Forty-nine consecutive patients were retrospectively included with minimum of 5-year follow-up (mean, 6.1; range, 5.1-7.3 years). The average age of surgery was 18.5 ± 5.0 years. We assessed radiographic measurements at preoperative (Preop), postoperative (PO) and final follow-up (FFU) period. Curve correction rate, correction loss rate, complications, accuracy of pedicle screws and SF-36 scores were analyzed.

Results

The average major curve was corrected from 58.0 ± 13.0° Preop to 16.0 ± 9.0° PO(p < 0.0001), and increased to 18.4 ± 8.6°(p = 0.12) FFU. This revealed a 72.7% correction rate and a correction loss of 2.4° (3.92%). The thoracic kyphosis decreased little at FFU (22 ± 12° to 20 ± 6°, (p = 0.25)). Apical vertebral rotation decreased from 2.1 ± 0.8 PreOP to 0.8 ± 0.8 at FFU (Nash-Moe grading, p < 0.01). Among total 831 pedicle screws, 56 (6.7%) were found to be malpositioned. Compared with 2069 age-matched Taiwanese, SF-36 scores showed inferior result in 2 variables: physical function and role physical.

Conclusion

Follow-up more than 5 years, the authors suggest that all-screw method is an efficient and safe method.

Keywords:
Adolescent idiopathic scoliosis (AIS); All-screw method; SF-36 questionnaire