Cargando…

All Pedicle Screw versus Hybrid Hook–Screw Instrumentation in the Treatment of Thoracic Adolescent Idiopathic Scoliosis (AIS): A Prospective Comparative Cohort Study

Background: Posterior spinal correction and fusion remains the most common surgical treatment in AIS. Surgeons currently favour all pedicle screw (AS) correction techniques with alternative implants being less utilised. The purpose of this study was to assess whether a hybrid hook–screw (HS) constru...

Descripción completa

Detalles Bibliográficos
Autores principales: Tsirikos, Athanasios I., McMillan, Tristan E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9408534/
https://www.ncbi.nlm.nih.gov/pubmed/36011112
http://dx.doi.org/10.3390/healthcare10081455
_version_ 1784774624694763520
author Tsirikos, Athanasios I.
McMillan, Tristan E.
author_facet Tsirikos, Athanasios I.
McMillan, Tristan E.
author_sort Tsirikos, Athanasios I.
collection PubMed
description Background: Posterior spinal correction and fusion remains the most common surgical treatment in AIS. Surgeons currently favour all pedicle screw (AS) correction techniques with alternative implants being less utilised. The purpose of this study was to assess whether a hybrid hook–screw (HS) construct could achieve similar outcomes. Methods: A single centre, prospective cohort study was conducted. Patients with moderate and severe thoracic AIS (Lenke 1) were included. Clinical and radiological results of a standardised hybrid HS technique were compared with those obtained with an AS construct. All patients had a minimum 2-year follow-up. Results: 160 patients were included in this series (80 patients/group). The HS group had significantly reduced surgical time, blood loss and implant density. Both techniques achieved ≥75% scoliosis correction. The HS group was superior in restoring thoracic kyphosis and global sagittal balance with an average 31% increase in kyphosis compared to 10% with the AS group (p < 0.001). There was significant improvement in SRS-22 scores at 2 years postoperative (p < 0.001) in both groups. There were no neurological or visceral complications related to instrumentation, no detected non-union and no reoperations. The HS implant cost was significantly lower than that of AS, with a mean instrumentation saving of almost £2000/patient. Conclusion: A standardised hybrid HS technique achieved excellent correction of thoracic scoliosis, high patient satisfaction and low complication rates in patients with thoracic AIS. These results were comparable to the AS group. The HS technique achieved better correction of thoracic kyphosis and sagittal balance than the AS technique, together with reduced surgical time, blood loss and implant cost.
format Online
Article
Text
id pubmed-9408534
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-94085342022-08-26 All Pedicle Screw versus Hybrid Hook–Screw Instrumentation in the Treatment of Thoracic Adolescent Idiopathic Scoliosis (AIS): A Prospective Comparative Cohort Study Tsirikos, Athanasios I. McMillan, Tristan E. Healthcare (Basel) Article Background: Posterior spinal correction and fusion remains the most common surgical treatment in AIS. Surgeons currently favour all pedicle screw (AS) correction techniques with alternative implants being less utilised. The purpose of this study was to assess whether a hybrid hook–screw (HS) construct could achieve similar outcomes. Methods: A single centre, prospective cohort study was conducted. Patients with moderate and severe thoracic AIS (Lenke 1) were included. Clinical and radiological results of a standardised hybrid HS technique were compared with those obtained with an AS construct. All patients had a minimum 2-year follow-up. Results: 160 patients were included in this series (80 patients/group). The HS group had significantly reduced surgical time, blood loss and implant density. Both techniques achieved ≥75% scoliosis correction. The HS group was superior in restoring thoracic kyphosis and global sagittal balance with an average 31% increase in kyphosis compared to 10% with the AS group (p < 0.001). There was significant improvement in SRS-22 scores at 2 years postoperative (p < 0.001) in both groups. There were no neurological or visceral complications related to instrumentation, no detected non-union and no reoperations. The HS implant cost was significantly lower than that of AS, with a mean instrumentation saving of almost £2000/patient. Conclusion: A standardised hybrid HS technique achieved excellent correction of thoracic scoliosis, high patient satisfaction and low complication rates in patients with thoracic AIS. These results were comparable to the AS group. The HS technique achieved better correction of thoracic kyphosis and sagittal balance than the AS technique, together with reduced surgical time, blood loss and implant cost. MDPI 2022-08-03 /pmc/articles/PMC9408534/ /pubmed/36011112 http://dx.doi.org/10.3390/healthcare10081455 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Tsirikos, Athanasios I.
McMillan, Tristan E.
All Pedicle Screw versus Hybrid Hook–Screw Instrumentation in the Treatment of Thoracic Adolescent Idiopathic Scoliosis (AIS): A Prospective Comparative Cohort Study
title All Pedicle Screw versus Hybrid Hook–Screw Instrumentation in the Treatment of Thoracic Adolescent Idiopathic Scoliosis (AIS): A Prospective Comparative Cohort Study
title_full All Pedicle Screw versus Hybrid Hook–Screw Instrumentation in the Treatment of Thoracic Adolescent Idiopathic Scoliosis (AIS): A Prospective Comparative Cohort Study
title_fullStr All Pedicle Screw versus Hybrid Hook–Screw Instrumentation in the Treatment of Thoracic Adolescent Idiopathic Scoliosis (AIS): A Prospective Comparative Cohort Study
title_full_unstemmed All Pedicle Screw versus Hybrid Hook–Screw Instrumentation in the Treatment of Thoracic Adolescent Idiopathic Scoliosis (AIS): A Prospective Comparative Cohort Study
title_short All Pedicle Screw versus Hybrid Hook–Screw Instrumentation in the Treatment of Thoracic Adolescent Idiopathic Scoliosis (AIS): A Prospective Comparative Cohort Study
title_sort all pedicle screw versus hybrid hook–screw instrumentation in the treatment of thoracic adolescent idiopathic scoliosis (ais): a prospective comparative cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9408534/
https://www.ncbi.nlm.nih.gov/pubmed/36011112
http://dx.doi.org/10.3390/healthcare10081455
work_keys_str_mv AT tsirikosathanasiosi allpediclescrewversushybridhookscrewinstrumentationinthetreatmentofthoracicadolescentidiopathicscoliosisaisaprospectivecomparativecohortstudy
AT mcmillantristane allpediclescrewversushybridhookscrewinstrumentationinthetreatmentofthoracicadolescentidiopathicscoliosisaisaprospectivecomparativecohortstudy