High-density and moderate-density implant constructs for adolescent idiopathic scoliosis have equivalent clinical and radiographic outcomes at 2 years.
Taylor J Jackson, Suken A Shah, Harry L Shufflebarger, Daniel J Sucato, Sumeet Garg, Paul Sponseller, David Clements, Nicholas D Fletcher, Peter O Newton, Amer F Samdani, A Noelle Larson
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引用次数: 0
Abstract
Purpose: Implant density for posterior spinal fusion in AIS remains controversial. As limited data exist to guide surgeons, we aimed to evaluate the effect of implant density on radiographic and patient reported outcomes (PROMs).
Methods: This is a retrospective review of prospectively collected multicenter data. Radiographic, perioperative, and PROMs were compared for patients treated with high-density (> 1.8) and moderate-density (≤ 1.8-1.4) screw constructs. Patients were stratified according to the Lenke classification.
Results: 1865 patients met inclusion criteria: 1225 high-density and 640 moderate-density screw construct patients. The groups had similar mean age (14.7 vs 14.6, p > 0.05) and sex (81.5% vs 79.5% female, p > 0.05). There were similar radiographic outcomes between groups [final curve magnitude (19° vs 19°, p = 0.540)] with only small differences in the percent correction for Lenke 2 curves (66% vs 61%, p = 0.001) producing a 1° difference in curve correction (19° vs 20°, p = 0.001) in the high-density group at 2 years. Excluding thoracoplasty patients, 2-year rib rotation was similar between the two groups (4.5° vs 6.3°, p < 0.05). The mean time to follow-up was shorter in the high-density group (4.5 vs 5 years, p < 0.001), but no statistically significant differences in the two-year SRS-22 scores.
Conclusion: Patients treated with both high and moderate-density constructs had similar SRS scores and radiographic results at 2-year follow-up. High-density constructs produced marginally better axial, sagittal, and coronal correction. However, these differences are small and not clinically meaningful with no difference in PROMs in curves ≤ 70°. The use of a moderate-density construct should be considered for routine AIS surgery.
期刊介绍：
Spine Deformity the official journal of the?Scoliosis Research Society is a peer-refereed publication to disseminate knowledge on basic science and clinical research into the?etiology?biomechanics?treatment?methods and outcomes of all types of?spinal deformities. The international members of the Editorial Board provide a worldwide perspective for the journal's area of interest.The?journal?will enhance the mission of the Society which is to foster the optimal care of all patients with?spine?deformities worldwide. Articles published in?Spine Deformity?are Medline indexed in PubMed.? The journal publishes original articles in the form of clinical and basic research. Spine Deformity will only publish studies that have institutional review board (IRB) or similar ethics committee approval for human and animal studies and have strictly observed these guidelines. The minimum follow-up period for follow-up clinical studies is 24 months.
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