Three-Dimensional Correction in Patients With Lenke 1 Adolescent Idiopathic Scoliosis

Ketencı, İsmail Emre; Yanık, Hakan Serhat; Demiröz, Serdar; Ulusoy, Ayhan; Erdem, Şevki

doi:10.1097/brs.0000000000001182

Cited by 25 publications

(9 citation statements)

References 13 publications

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“…Two studies in 2016 showed support for a positive correlation between coronal curve correction and anchor density. Ketenci et al [15] studied 76 matched Lenke 1 patients and equally divided these patients into the consecutive pedicle screw group (mean anchor density 2) and the interval pedicle screw group (mean anchor density 1.14). A significantly better coronal and rotational correction of thoracic curve was observed in the consecutive pedicle screw group.…”

Section: Discussionmentioning

confidence: 99%

“…Maintaining adequate lumbar lordosis is also essential to balanced sagittal profiles in long-segments instrumented spinal surgery [26]. Larson et al [13] found high anchor density was associated with postoperative hypokyphosis in Lenke 1,2 AIS patients, while several other studies reported no correlations between anchor density and thoracic kyphosis/lumbar lordosis correction [14, 15, 17].…”

Section: Discussionmentioning

confidence: 99%

“…Bharucha et al [10] reported no differences of trunk rotation correction between anchor density above or below 1.3 (mean anchor density of all 91 patients). Whereas Ketenci et al [15] found consecutive pedicle screws construct (anchor density 2.0) has significant better apical vertebral rotation correction over interval pedicle screw construct (anchor density 1.14). In our study, there was no correlation between anchor density and apical vertebral rotation in all patients and all subgroups of different curve types, curve magnitudes and curve flexibilities.…”

Section: Discussionmentioning

confidence: 99%

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The correlations between the anchor density and the curve correction of adolescent idiopathic scoliosis surgery

Yeh

Niu

Chen

et al. 2019

BMC Musculoskelet Disord

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BackgroundThe optimal anchor density in adolescent idiopathic scoliosis (AIS) surgery to achieve good curve correction remains unclear. The purpose of the study is to analyze the correlations between three-dimensional curve correction and anchor density in the pedicle screw-based posterior fusion of AIS.MethodsOne hundred and twenty-seven AIS patients receiving primary posterior fusion with pedicle screw instrumentation were retrospectively reviewed. Anchor density (AD) was defined as the screws number per fused spinal segment. The correlations between three-dimensional curve correction radiographic parameters and anchor density were analyzed with subgroup analysis based on different curve types, curve magnitudes, and curve flexibilities. The differences of curve correction parameters between the low-density (AD ≤1.4), middle-density (1.4 < AD ≤1.7) and high-density (AD > 1.7) groups were also calculated. Independent t-test, analysis of variance (ANOVA), and Pearson’s correlation coefficient were used for statistical analysis.ResultsThere were no correlations between the anchor density and the coronal curve correction or apical vertebral rotation (AVR) correction. In the sagittal plane, mild positive correlations existed between anchor density and thoracic kyphosis correction in all patients (r = 0.27, p = 0.002). Subgroup analysis revealed similar mild positive correlations in Lenke 1 (r = 0.31, p = 0.02), Lenke 1–3 (r = 0.27, p = 0.01), small curves (40°-60°, r = 0.38, p < 0.001), and flexible curves (flexibility > 40%, r = 0.34, p = 0.01).There were no differences between low-density (mean 1.31), middle-density (mean 1.55), and high-density (mean 1.83) in terms of coronal or axial curve correction parameters. Low-density group has longer fused level (mean difference 2.14, p = 0.001) and smaller thoracic kyphosis correction (mean difference 9.25°, p = 0.004) than high-density group.ConclusionIn our study, the anchor density was not related to coronal or axial curve corrections. Mild positive correlations with anchor density were found in thoracic kyphosis correction, especially in patients with smaller and flexible curves. Low anchor density with longer fusion level achieves similar curve corrections with middle or high anchor density in adolescent idiopathic scoliosis surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The correlations between the anchor density and the curve correction of adolescent idiopathic scoliosis surgery

Yeh

Niu

Chen

et al. 2019

BMC Musculoskelet Disord

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“…Pedicle screw construct systems have been increasingly popular for treating patients with spinal deformities, [ 4 – 7 ] and a significant correlation between the implant density and major curve correction has been reported [ 8 – 10 ]. However, substantial research has shown that low density (LD) screw constructs can provide similar radiographic and clinical outcomes [ 11 – 15 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of low density and high density pedicle screw instrumentation in Lenke 1 adolescent idiopathic scoliosis

Shen

Jiang

Luo

et al. 2017

BMC Musculoskelet Disord

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BackgroundThe correlation between implant density and deformity correction has not yet led to a precise conclusion in adolescent idiopathic scoliosis (AIS). The aim of this study was to evaluate the effects of low density (LD) and high density (HD) pedicle screw instrumentation in terms of the clinical, radiological and Scoliosis Research Society (SRS)-22 outcomes in Lenke 1 AIS.MethodsWe retrospectively reviewed 62 consecutive Lenke 1 AIS patients who underwent posterior spinal arthrodesis using all-pedicle screw instrumentation with a minimum follow-up of 24 months. The implant density was defined as the number of screws per spinal level fused. Patients were then divided into two groups according to the average implant density for the entire study. The LD group (n = 28) had fewer than 1.61 screws per level, while the HD group (n = 34) had more than 1.61 screws per level. The radiographs were analysed preoperatively, postoperatively and at final follow-up. The perioperative and SRS-22 outcomes were also assessed. Independent sample t tests were used between the two groups.ResultsComparisons between the two groups showed no significant differences in the correction of the main thoracic curve and thoracic kyphosis, blood transfusion, hospital stay, and SRS-22 scores. Compared with the HD group, there was a decreased operating time (278.4 vs. 331.0 min, p = 0.004) and decreased blood loss (823.6 vs. 1010.9 ml, p = 0.048), pedicle screws needed (15.1 vs. 19.6, p < 0.001), and implant costs ($10,191.0 vs. $13,577.3, p = 0.003) in the LD group.ConclusionsBoth low density and high density pedicle screw instrumentation achieved satisfactory deformity correction in Lenke 1 AIS patients. However, the operating time and blood loss were reduced, and the implant costs were decreased with the use of low screw density constructs.

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“…The aim of this article is to describe the innovative posterior one stage surgical technique summarized with the acronym Hi-PoAD, which consists of simultaneous application of different surgical strategies, all well described individually, as high-density screwing [6][7][8][9], Ponte osteotomies [10][11][12][13], asymmetric rods contouring [14][15][16], direct vertebral rotation (DVR) [17] in the treatment of rigid AdIS (with less than 25% of correction at bending supine radiographs), the complication rate and the clinical and radiographical results obtained at minimum 2 years follow-up (FU) in a cohort of patients over 40 years treated.…”

Section: Introductionmentioning

confidence: 99%

Hi-PoAD technique for Adolescent Idiopathic Scoliosis in Adult: Personal case series

et al. 2021

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Purpose The aim of this article is to present an original surgical technique for the treatment of rigid Adult Idiopathic Scoliosis (AdIS) and the results at minimum 2 years follow-up in a cohort of 40 patients. Methods We retrospectively reviewed 40 patients affected by rigid AdIS, older than 40 years and operated with a posterior one stage surgical technique summarized with the acronym Hi-PoAD, (high-density pedicle screws, Ponte osteotomies, asymmetric rods contouring, direct vertebral rotation). The demographic and surgical data were collected, and the improvement of clinical scores and radiologic parameters was obtained after surgery, at 1 and 2 years and at final follow-up, to assess deformity correction, coronal and sagittal balance and clinical outcome. Results The average follow-up was 2.9 years (range 2–3.5). Average coronal Cobb angle decreased from 65.0° ± 8.4 to 18.9° ± 3.9 (p < 0.01). Rotation sagittal angle decreased from 26.2° ± 4.4° to 12.4° ± 2.8° (p < 0.01). Mean thoracic kyphosis improved from 23.1° ± 3.6° to 36.0° ± 3.9°. SRS-22 improved form 2.9 ± 0.4 to 3.7 ± 0.6 (p < 0.01). Four early post-operative deep wound infections were observed, all healed after debridement and implant retention. No mechanical complication, junctional kyphosis, deformity progression or non-union were recorded at the last follow-up. Conclusions Hi-PoAD technique proved to be safe and effective in the treatment of rigid Adult Idiopathic Scoliosis. The reason for the success is related to the combined strategies adopted, that dissipates corrective forces over several levels, reducing mechanical stress at the screw–bone interface and optimizing corrective potential.

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Three-Dimensional Correction in Patients With Lenke 1 Adolescent Idiopathic Scoliosis

Abstract: 3.

Cited by 25 publications

References 13 publications

The correlations between the anchor density and the curve correction of adolescent idiopathic scoliosis surgery

The correlations between the anchor density and the curve correction of adolescent idiopathic scoliosis surgery

Comparison of low density and high density pedicle screw instrumentation in Lenke 1 adolescent idiopathic scoliosis

Hi-PoAD technique for Adolescent Idiopathic Scoliosis in Adult: Personal case series

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