A uniquely shaped rod improves curve correction in surgical treatment of adolescent idiopathic scoliosis
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A uniquely shaped rod improves curve correction in surgical treatment of adolescent idiopathic scoliosis. / Gehrchen, Poul Martin; Ohrt-Nissen, Søren; Hallager, Dennis Winge; Dahl, Benny.
In: Spine, Vol. 41, No. 14, 2016, p. 1139-1145.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - A uniquely shaped rod improves curve correction in surgical treatment of adolescent idiopathic scoliosis
AU - Gehrchen, Poul Martin
AU - Ohrt-Nissen, Søren
AU - Hallager, Dennis Winge
AU - Dahl, Benny
PY - 2016
Y1 - 2016
N2 - Study Design. A retrospective cohort study. Objective. The aim of this study is to determine the initial curve correction in patients surgically treated for adolescent idiopathic scoliosis (AIS) using either beam-like rods (BRs) or traditional circular rods (CRs). Summary of Background Data. Posterior fusion using all pedicle screw instrumentation has become the standard for the surgical treatment of AIS. Traditionally, the rod is circular in the cross-sectional plane. Recent biomechanical studies suggest that a beam-like structure of the rod may enhance the stiffness of the construct and thereby possibly improve curve correction. Methods. Two consecutive series of patients surgically treated for AIS between May 2011 and May 2015 were included in the study. Patients were all treated with an ultralow profile all-pedicle screw implant system. In the first series, conventional 5.5mm CoCr CR were used, and in the second series, 5.5mm CoCr BR were used. Antero-posterior and lateral radiographs preoperatively and within seven days after surgery were used to measure the correction obtained. Results. The first 60 patients were operated with CR and the subsequent 69 with BR. There was no statistical difference in age, gender, preoperative curve magnitude, Lenke type, or number of levels instrumented (P=0.451). Major curve correction was significantly better in the BR group than in the CR group (66 vs. 57%) (P<0.001). We found no difference in preoperative flexibility, secondary curve correction, sagittal balance, or coronal balance (P>0.058). A postoperative decrease in thoracic kyphosis was seen with no significant difference between groups. Median T5-T12 change was -7° versus -3° for BR and CR, respectively (P=0.051). Conclusion. A BR design results in a significantly better curve correction than conventional rods, but the difference is moderate and the clinical value is uncertain.
AB - Study Design. A retrospective cohort study. Objective. The aim of this study is to determine the initial curve correction in patients surgically treated for adolescent idiopathic scoliosis (AIS) using either beam-like rods (BRs) or traditional circular rods (CRs). Summary of Background Data. Posterior fusion using all pedicle screw instrumentation has become the standard for the surgical treatment of AIS. Traditionally, the rod is circular in the cross-sectional plane. Recent biomechanical studies suggest that a beam-like structure of the rod may enhance the stiffness of the construct and thereby possibly improve curve correction. Methods. Two consecutive series of patients surgically treated for AIS between May 2011 and May 2015 were included in the study. Patients were all treated with an ultralow profile all-pedicle screw implant system. In the first series, conventional 5.5mm CoCr CR were used, and in the second series, 5.5mm CoCr BR were used. Antero-posterior and lateral radiographs preoperatively and within seven days after surgery were used to measure the correction obtained. Results. The first 60 patients were operated with CR and the subsequent 69 with BR. There was no statistical difference in age, gender, preoperative curve magnitude, Lenke type, or number of levels instrumented (P=0.451). Major curve correction was significantly better in the BR group than in the CR group (66 vs. 57%) (P<0.001). We found no difference in preoperative flexibility, secondary curve correction, sagittal balance, or coronal balance (P>0.058). A postoperative decrease in thoracic kyphosis was seen with no significant difference between groups. Median T5-T12 change was -7° versus -3° for BR and CR, respectively (P=0.051). Conclusion. A BR design results in a significantly better curve correction than conventional rods, but the difference is moderate and the clinical value is uncertain.
KW - adolescent idiopathic scoliosis
KW - beam-like rod
KW - circular rod
KW - curve correction
KW - pedicle screw implant
KW - posterior fusion
KW - rod stiffness
KW - surgical fusion
KW - thoracic kyphosis
KW - ultralow profile screw
U2 - 10.1097/BRS.0000000000001504
DO - 10.1097/BRS.0000000000001504
M3 - Journal article
C2 - 26890957
AN - SCOPUS:84958780975
VL - 41
SP - 1139
EP - 1145
JO - Spine
JF - Spine
SN - 0362-2436
IS - 14
ER -
ID: 178841863