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All pedicle screw instrumentation for Scheuermann's kyphosis correction: is it worth it?
Spine J. 2009 Apr; 9(4):296-302.SJ

Abstract

BACKGROUND CONTEXT

Scheuermann's kyphosis has long been treated by a two-staged fusion and instrumentation with a hybrid construct using hooks, pedicle screws, and sublaminar wires. Recent interest in all pedicle screw constructs led to its use in the treatment of Scheuermann's kyphosis. Evaluation of this newly described application is needed.

PURPOSE

To compare the results of segmental all pedicle screw constructs versus two-staged hybrid instrumentation in patients with Scheuermann's kyphosis analyzing the amount of correction and incidence of complications.

STUDY DESIGN

Retrospective case series reporting on two groups of patients with Scheuermann's kyphosis treated with single-staged all pedicle screws technique versus two-staged anterior release and posterior hybrid instrumentation followed-up for a minimum of 2 years.

PATIENT SAMPLE

The study included 33 patients divided into two groups. The average age was 15 years+9 months and 16 years+8 months, respectively. The average preoperative dorsal kyphosis was 85.5 degrees (Group 1) and 79.8 degrees (Group 2).

OUTCOME MEASURES

The deformity was measured by Cobb's method preoperatively, postoperatively, and at final follow-up. Operative time and blood loss were also measured and recorded. The results of the Scoliosis Research Society (SRS)-30 questionnaire were also reviewed.

METHODS

The study included 16 patients who underwent a single-staged correction by segmental all pedicle screw constructs and multiple-level posterior osteotomies (Group 1) and 17 who underwent a two-staged fusion and instrumentation with a hybrid construct (Group 2).

RESULTS

Both groups were followed for a minimum of 2 years. The deformity correction of Group 1 had an average of 52.2% postoperatively with 2.4% loss at final follow-up in comparison to Group 2 where the correction was 48.7% postoperatively with 3.1% loss at final follow-up. The operative time was considerably less in Group 1 with an average of 215 minutes than Group 2 with an average of 315 minutes. The average blood loss was 620cc in Group 1 and 910cc in Group 2. The SRS-30 questionnaire in Group 1 averaged 134 and in Group 2 averaged 120.

CONCLUSIONS

The use of multiple-level all pedicle screws technique allowed a rigid anchor for posterior correction of the deformity with less operative time, blood loss, and hospital stay without the need for anterior release. A better correction was achieved and preserved with the use of all pedicle screw constructs. This technique is a useful modality in the treatment of Scheuermann's kyphosis.

Authors+Show Affiliations

Orthopaedic Department, Faculty of Medicine, Cairo University, Geiza, Egypt. waelkoptan@yahoo.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18640879

Citation

Koptan, Wael M T., et al. "All Pedicle Screw Instrumentation for Scheuermann's Kyphosis Correction: Is It Worth It?" The Spine Journal : Official Journal of the North American Spine Society, vol. 9, no. 4, 2009, pp. 296-302.
Koptan WM, Elmiligui YH, Elsebaie HB. All pedicle screw instrumentation for Scheuermann's kyphosis correction: is it worth it? Spine J. 2009;9(4):296-302.
Koptan, W. M., Elmiligui, Y. H., & Elsebaie, H. B. (2009). All pedicle screw instrumentation for Scheuermann's kyphosis correction: is it worth it? The Spine Journal : Official Journal of the North American Spine Society, 9(4), 296-302. https://doi.org/10.1016/j.spinee.2008.05.011
Koptan WM, Elmiligui YH, Elsebaie HB. All Pedicle Screw Instrumentation for Scheuermann's Kyphosis Correction: Is It Worth It. Spine J. 2009;9(4):296-302. PubMed PMID: 18640879.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - All pedicle screw instrumentation for Scheuermann's kyphosis correction: is it worth it? AU - Koptan,Wael M T, AU - Elmiligui,Yasser H, AU - Elsebaie,Hazem B, Y1 - 2008/07/21/ PY - 2007/12/24/received PY - 2008/04/16/revised PY - 2008/05/19/accepted PY - 2008/7/22/pubmed PY - 2009/5/12/medline PY - 2008/7/22/entrez SP - 296 EP - 302 JF - The spine journal : official journal of the North American Spine Society JO - Spine J VL - 9 IS - 4 N2 - BACKGROUND CONTEXT: Scheuermann's kyphosis has long been treated by a two-staged fusion and instrumentation with a hybrid construct using hooks, pedicle screws, and sublaminar wires. Recent interest in all pedicle screw constructs led to its use in the treatment of Scheuermann's kyphosis. Evaluation of this newly described application is needed. PURPOSE: To compare the results of segmental all pedicle screw constructs versus two-staged hybrid instrumentation in patients with Scheuermann's kyphosis analyzing the amount of correction and incidence of complications. STUDY DESIGN: Retrospective case series reporting on two groups of patients with Scheuermann's kyphosis treated with single-staged all pedicle screws technique versus two-staged anterior release and posterior hybrid instrumentation followed-up for a minimum of 2 years. PATIENT SAMPLE: The study included 33 patients divided into two groups. The average age was 15 years+9 months and 16 years+8 months, respectively. The average preoperative dorsal kyphosis was 85.5 degrees (Group 1) and 79.8 degrees (Group 2). OUTCOME MEASURES: The deformity was measured by Cobb's method preoperatively, postoperatively, and at final follow-up. Operative time and blood loss were also measured and recorded. The results of the Scoliosis Research Society (SRS)-30 questionnaire were also reviewed. METHODS: The study included 16 patients who underwent a single-staged correction by segmental all pedicle screw constructs and multiple-level posterior osteotomies (Group 1) and 17 who underwent a two-staged fusion and instrumentation with a hybrid construct (Group 2). RESULTS: Both groups were followed for a minimum of 2 years. The deformity correction of Group 1 had an average of 52.2% postoperatively with 2.4% loss at final follow-up in comparison to Group 2 where the correction was 48.7% postoperatively with 3.1% loss at final follow-up. The operative time was considerably less in Group 1 with an average of 215 minutes than Group 2 with an average of 315 minutes. The average blood loss was 620cc in Group 1 and 910cc in Group 2. The SRS-30 questionnaire in Group 1 averaged 134 and in Group 2 averaged 120. CONCLUSIONS: The use of multiple-level all pedicle screws technique allowed a rigid anchor for posterior correction of the deformity with less operative time, blood loss, and hospital stay without the need for anterior release. A better correction was achieved and preserved with the use of all pedicle screw constructs. This technique is a useful modality in the treatment of Scheuermann's kyphosis. SN - 1878-1632 UR - https://www.unboundmedicine.com/medline/citation/18640879/All_pedicle_screw_instrumentation_for_Scheuermann's_kyphosis_correction:_is_it_worth_it L2 - https://linkinghub.elsevier.com/retrieve/pii/S1529-9430(08)00216-7 DB - PRIME DP - Unbound Medicine ER -