Journal article
Deformity correction using proximal hooks and distal screws (PHDSs) improves radiological metrics in adolescent idiopathic scoliosis
European spine journal, Vol.30(3), pp.686-691
03/01/2021
DOI: 10.1007/s00586-020-06442-3
PMID: 32405796
Abstract
Purpose Surgical correction for AIS has evolved from all hooks to hybrids or all screw constructs. Limited literature exists reporting outcomes using PHDS for posterior spinal fusion (PSF). This is the largest series in evaluating results of PHDS technique. Methods A retrospective review of consecutive AIS patients undergoing PSF by a single surgeon between 2006 and 2015 was performed. All eligible patients met a minimum 2-year follow-up. Patient demographics and radiographical parameters (radiographic shoulder height (RSH), T1 tilt, clavicle angle) at baseline, 6-week and 2-year post-operation were recorded. The primary outcome was difference in RSH from baseline measurements evaluated using repeated measures one-way analysis of variance with Bonferroni correction. Results A total of 219 patients (mean age at surgery: 13.68 years; 82% female) were included. The mean follow-up was 41.2 months (range 24-108 months). The RSH was significantly improved from - 14.7 +/- 10.38 mm to 8.0 +/- 6.9 mm (P < 0.0001). Clavicle angle was improved from 2.13 degrees to 1.31 degrees (P < 0.0001). T1 tilt was improved from 5.6 degrees to 2.2 degrees (P < 0.0001). At last follow-up, 95.8% of patients were shoulder balanced. There was a significant improvement of Cobb angle with an average correction of the upper thoracic curve of 42% and main thoracic curve of 67%. Conclusion The PHDS demonstrates the potential for additional shoulder balance improvement. Extension of fusion to structural proximal thoracic spine is the key to success for shoulder balance. It remains to be seen whether these improvements will translate into improved clinical outcomes in the longer term.
Details
- Title: Subtitle
- Deformity correction using proximal hooks and distal screws (PHDSs) improves radiological metrics in adolescent idiopathic scoliosis
- Creators
- Pawin Gajaseni - Phramongkutklao HospitalLuca Labianca - Sapienza University of RomePiyush Kalakoti - University of IowaAndrew J. Pugely - University of IowaStuart L. Weinstein - University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- European spine journal, Vol.30(3), pp.686-691
- Publisher
- Springer Nature
- DOI
- 10.1007/s00586-020-06442-3
- PMID
- 32405796
- ISSN
- 0940-6719
- eISSN
- 1432-0932
- Number of pages
- 6
- Language
- English
- Date published
- 03/01/2021
- Academic Unit
- Stead Family Department of Pediatrics; Orthopedics and Rehabilitation
- Record Identifier
- 9984304692402771
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