Adolescent idiopathic scoliosis: Results of treatment with hybrid posterior instrumentation

Abstract

Purpose Report on the clinical and radiological results obtained by surgical treatment of adolescent idiopathic scoliosis by means of hybrid posterior instrumentation. The repercussions of surgery on the patients’ quality of life are also described. Materials and methods Retrospective study of 26 patients operated between 2001 and 2006, with a mean follow-up of 37.8 months. In terms of the Lenke classification, 42.3% of patients had type 1 curves, 46.2% type 3 curves, 7.7% type 5 curves, and one case of type VI curves. All patients were subjected to a hybrid posterior instrumentation with distal pedicular screws and proximal hooks. Transfusion needs and complications were duly recorded. A clinical assessment was performed by means of the SRS-22 questionnaire. A radiological assessment was conducted preoperatively, postoperatively and at the end of follow-up. Results There were three superficial infections, one hemothorax and one hook dislocation. The administration of the SRS-22 questionnaire produced the following mean scores: 4.41 for pain, 4.39 for activity, 3.91 for self-image, 3.98 for mental health and 3.81 for satisfaction. Mean post-surgical radiological correction for thoracic and lumbar curves was 58% and 60%, respectively, with a mean loss of 7 and 5.5 degrees at the end of follow-up. There were no cases of pseudarthrosis. Discussion and conclusions Hybrid posterior instrumentation and fusion is an efficient and safe technique, with a low rate of pseudoarthrosis and failure. Results were good as regards pain and activity, but fair in terms of self-image and personal satisfaction. We found no statistically significant association between the patients’ age, the degree of curve correction and the score on the SRS-22 questionnaire.