Analysis of posterior pedicle screw-only constructs in surgical treatment of adolescent idiopathic scoliosis with a minimum three-year follow-up

Abstract

To evaluate clinical outcomes of a group of adolescent idiopathic scoliosis (AIS) patients undergoing posterior pedicle screw-only instrumentations. Between April 2002 and July 2006, 121 AIS patients (93 female and 28 male, average age at operation was 15.5 years which ranged from 10 to 20 years) received posterior pedicle screw-only instrumentation and fusion. All the patients were evaluated by the various-parameters measured in X-ray films before and after surgery, including Cobb angle on coronal plane, Cobb angle on sagittal plane, clavicle angle and shoulder height difference, lowest instrumented vertebrae (LIV) angulation, proximal junction kyphotic angle, the distances of central sacral vertical line (CSVL) to the LIV, to the apical vertebra and to the C(7) plumb line respectively. Complications were followed. An average of (11.0 + or - 1.5) levels was fused. An average coronal correction of proximal thoracic curve was 41.8%, of thoracic curve was 70.8%, of thoracolumbar/lumbar curves was 74.0%. No significant change was found in sagittal alignment. Shoulder balance and apex vertebral to central sacral line were restored well. There were no pseudoarthroses and loss of correction during the follow-ups. One adding-on, 4 proximal thoracic decompensation and 15 proximal junction kyphosis were found during the follow-ups. Posterior pedicle screw-only instrumentation and fusion has excellent radiographic and clinical results with minimal complications in the surgical treatment of AIS.