Bivertebral autostable claws for the proximal fixation in thoracic adolescent idiopathic scoliosis surgery

Simon, Anne; Ferrero, Emmanuelle; Mazda, Keyvan; Ilharreborde, Brice

doi:10.1007/s43390-020-00040-5

Cited by 6 publications

(4 citation statements)

References 39 publications

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“…The PJK incidence in AIS ranges from 1.8% to 15%, whatever the construct. 7,8,[19][20][21] Suggested by Ferrero et al, 21 PJK risk factors can be classified either as modifiable or nonmodifiable. As an unmodifiable factor, a high pelvic incidence appears to increase the risk of PJK.…”

Section: Discussionmentioning

confidence: 99%

“…The PJK incidence in AIS ranges from 1.8% to 15%, whatever the construct 7,8,19–21. Suggested by Ferrero et al,21 PJK risk factors can be classified either as modifiable or nonmodifiable.…”

Section: Discussionmentioning

confidence: 99%

“…In this construct, the proximal junctional kyphosis (PJK) incidence is around 10%. 7,8 Thoracic screw disadvantages are mainly related to neurological risks 9 and a long learning curve. 10 Nevertheless, thoracic screws offer a more stable fixation and a greater contraction/ distraction strength at the top.…”

mentioning

confidence: 99%

“…In all these studies, the spine is instrumented with lumbar pedicle screws, sublaminar thoracic bands and claws (transverse and pedicular hook) at the top. In this construct, the proximal junctional kyphosis (PJK) incidence is around 10% 7,8. Thoracic screw disadvantages are mainly related to neurological risks9 and a long learning curve 10.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Proximal Fixation in Adolescent Scoliosis Lenke 1 and 3 Treated by Posteromedial Translation Using Sublaminar Bands

Langlais

Rougereau

Brun-Cottan

et al. 2021

Clinical Spine Surgery: A Spine Publication

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or Background Data: Numerous studies have focused on the efficacy, safety, and restoration of thoracic kyphosis in adolescent idiopathic scoliosis surgery using posteromedial translation method with sublaminar bands and hook claws at the top. The relevance of exchanging the penultimate anchor, that is, the pedicle hook with a pedicle screw in a hybrid construction has not yet been assessed.Objective: Our objective was to assess, in adolescent scoliosis Lenke 1 and 3 operated by posteromedial translation using sublaminar bands, the proximal fixation claw influence (transverse-pedicular hook vs. transverse hook-pedicular screw) for postoperative correction and the proximal junctional kyphosis (PJK) at 2 years follow-up. Materials and Methods:A comparative monocentric retrospective study included adolescent idiopathic scoliosis thoracic requiring surgery, between 2015 and 2017, with 2 years followup. Clinical (complications, revision surgery, and scoliosis research society-30) and radiographic (coronal and sagittal parameters) assessment were reported. Radiologic PJK was defined by a proximal junctional angle increase of 10 degrees or more between postoperative period and the last follow-up.Results: Sixty patients (age at surgery = 16 ± 2 y; mean Cobb angle = 58.2 ± 12 degrees) were divided into 2 similar groups according to upper fixation: transverse-pedicular hook (H-H) and transverse hook-pedicle screw (S-H). No statistical differences were found for correction parameters (P > 0.05). We reported 2 cases of PJK in H-H group (N = 2/30 = 6.6%) and none in S-H group (N = 0/30) (P = 0.1) none requiring revision. No infectious or neurological events were reported. Mean scoliosis research society-30 was 126 ± 12.7 in H-H group whereas 129.3 ± 10 in S-H group (P = 0.4).Conclusions: No differences in postoperative correction and clinical results at 2 years follow-up were found. A claw with transverse-pedicular hook increase proximal junctional angle without significant increase on radiographic PJK incidence compared with a claw with transverse hook and pedicle screws.

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