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Comparative Study
. 2017 Aug 2;18(1):336.
doi: 10.1186/s12891-017-1695-x.

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

Mingkui Shen  1 , Honghui Jiang  2 , Ming Luo  1 , Wengang Wang  1 , Ning Li  1 , Lulu Wang  1 , Lei Xia  3
Affiliations
Comparative Study

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

Mingkui Shen et al. BMC Musculoskelet Disord. .

Abstract

Background: The 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.

Methods: We 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.

Results: Comparisons 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.

Conclusions: Both 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.

Keywords: Adolescent idiopathic scoliosis; High density; Implant density; Low density.

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Conflict of interest statement

Ethics approval and consent to participate

This retrospective study was approved by the Ethics Committee of the First Affiliated Hospital of Zhengzhou University. The consent has been received from the parents of the adolescence featured in this study.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
A high-density pedicle screw construct was used. Preoperative standing anteroposterior (a) and lateral radiographs (b). Final follow-up standing anteroposterior (c) and lateral radiographs (d)
Fig. 2
Fig. 2
A low-density pedicle screw construct was used. Preoperative standing anteroposterior (a) and lateral radiographs (b). Final follow-up standing anteroposterior (c) and lateral radiographs (d)
Fig. 3
Fig. 3
Correlation analysis between the implant density and correction rate of the MT curve for 2 weeks following the operation
Fig. 4
Fig. 4
Correlation analysis between the implant density and correction rate of the MT curve for the final follow-up
See this image and copyright information in PMC

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References

    1. Riseborough EJ, Wynne-Davies R. A genetic survey of idiopathic scoliosis in Boston, Massachusetts. J Bone Joint Surg Am. 1973;55(5):974–982. doi: 10.2106/00004623-197355050-00006. - DOI - PubMed
    1. Weinstein SL, Dolan LA, Cheng JC, Danielsson A, Morcuende JA. Adolescent idiopathic scoliosis. Lancet (London, England) 2008;371(9623):1527–1537. doi: 10.1016/S0140-6736(08)60658-3. - DOI - PubMed
    1. Lenke LG, Betz RR, Harms J, Bridwell KH, Clements DH, Lowe TG, Blanke K. Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis. J Bone Joint Surg Am. 2001;83-a(8):–1169, 1181. - PubMed
    1. Cheng I, Kim Y, Gupta MC, Bridwell KH, Hurford RK, Lee SS, Theerajunyaporn T, Lenke LG. Apical sublaminar wires versus pedicle screws--which provides better results for surgical correction of adolescent idiopathic scoliosis? Spine. 2005;30(18):2104–2112. doi: 10.1097/01.brs.0000179261.70845.b7. - DOI - PubMed
    1. Kuklo TR, Potter BK, Jr PD, Lenke LG. Monaxial versus multiaxial thoracic pedicle screws in the correction of adolescent idiopathic scoliosis. Spine. 2005;30(18):2113–2120. doi: 10.1097/01.brs.0000179260.73267.f4. - DOI - PubMed

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