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Utilization of Offset Iliac Connectors as Anchoring Sites in Severe Rigid Scoliosis: New Technique

STUDY DESIGN: This was a prospective cohort study. OBJECTIVES: To introduce the iliac connectors as fixation options in spinal constructs used for correction of severe scoliosis at locations other than the lumbopelvic region. METHODS: Nine patients with severe rigid scoliosis undergoing surgical rel...

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Autores principales: Barakat, Ahmed, Mansy, Yasser El, Saghir, Hesham El
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8119916/
https://www.ncbi.nlm.nih.gov/pubmed/32875886
http://dx.doi.org/10.1177/2192568220914233
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author Barakat, Ahmed
Mansy, Yasser El
Saghir, Hesham El
author_facet Barakat, Ahmed
Mansy, Yasser El
Saghir, Hesham El
author_sort Barakat, Ahmed
collection PubMed
description STUDY DESIGN: This was a prospective cohort study. OBJECTIVES: To introduce the iliac connectors as fixation options in spinal constructs used for correction of severe scoliosis at locations other than the lumbopelvic region. METHODS: Nine patients with severe rigid scoliosis undergoing surgical release and posterior instrumentation in the period between January 2013 and January 2015 were included in this prospective cohort study. Mean age was 18.4 years; 8 had triple structural curves, and the remaining patient had double structural curves. Cobb angles of the primary and compensatory curves were compared with the immediate, 1-year, and 2-year postoperative measurements using the F test, with P value ≤.05 indicating statistical significance. Screw densities of the final constructs were calculated and compared with the screw densities when the offset iliac connectors were not used. RESULTS: One to 4 offset iliac connectors were used in all 9 patients, increasing screw density by a mean of 6.24 (P < .001). The mean Cobb angle of the major curve was corrected from 98.44° to 58.2° (P < .001), that of the first compensatory curve, from 56.55° to 38.33° (P < .001), and that of the second compensatory curve, from 40.75° to 26.63° (P < .001). There were no intraoperative neurological complications. After a mean follow-up of 30.6 months, the construct remained stable in all patients with no loss of correction. CONCLUSION: Offset iliac connectors can be a valuable tool to increase screw density in correction of severe scoliosis, thus increasing overall biomechanical strength of the final construct.
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spelling pubmed-81199162021-05-21 Utilization of Offset Iliac Connectors as Anchoring Sites in Severe Rigid Scoliosis: New Technique Barakat, Ahmed Mansy, Yasser El Saghir, Hesham El Global Spine J Original Articles STUDY DESIGN: This was a prospective cohort study. OBJECTIVES: To introduce the iliac connectors as fixation options in spinal constructs used for correction of severe scoliosis at locations other than the lumbopelvic region. METHODS: Nine patients with severe rigid scoliosis undergoing surgical release and posterior instrumentation in the period between January 2013 and January 2015 were included in this prospective cohort study. Mean age was 18.4 years; 8 had triple structural curves, and the remaining patient had double structural curves. Cobb angles of the primary and compensatory curves were compared with the immediate, 1-year, and 2-year postoperative measurements using the F test, with P value ≤.05 indicating statistical significance. Screw densities of the final constructs were calculated and compared with the screw densities when the offset iliac connectors were not used. RESULTS: One to 4 offset iliac connectors were used in all 9 patients, increasing screw density by a mean of 6.24 (P < .001). The mean Cobb angle of the major curve was corrected from 98.44° to 58.2° (P < .001), that of the first compensatory curve, from 56.55° to 38.33° (P < .001), and that of the second compensatory curve, from 40.75° to 26.63° (P < .001). There were no intraoperative neurological complications. After a mean follow-up of 30.6 months, the construct remained stable in all patients with no loss of correction. CONCLUSION: Offset iliac connectors can be a valuable tool to increase screw density in correction of severe scoliosis, thus increasing overall biomechanical strength of the final construct. SAGE Publications 2020-03-25 2021-05 /pmc/articles/PMC8119916/ /pubmed/32875886 http://dx.doi.org/10.1177/2192568220914233 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Articles
Barakat, Ahmed
Mansy, Yasser El
Saghir, Hesham El
Utilization of Offset Iliac Connectors as Anchoring Sites in Severe Rigid Scoliosis: New Technique
title Utilization of Offset Iliac Connectors as Anchoring Sites in Severe Rigid Scoliosis: New Technique
title_full Utilization of Offset Iliac Connectors as Anchoring Sites in Severe Rigid Scoliosis: New Technique
title_fullStr Utilization of Offset Iliac Connectors as Anchoring Sites in Severe Rigid Scoliosis: New Technique
title_full_unstemmed Utilization of Offset Iliac Connectors as Anchoring Sites in Severe Rigid Scoliosis: New Technique
title_short Utilization of Offset Iliac Connectors as Anchoring Sites in Severe Rigid Scoliosis: New Technique
title_sort utilization of offset iliac connectors as anchoring sites in severe rigid scoliosis: new technique
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8119916/
https://www.ncbi.nlm.nih.gov/pubmed/32875886
http://dx.doi.org/10.1177/2192568220914233
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