Chinese Journal of Tissue Engineering Research ›› 2011, Vol. 15 ›› Issue (22): 4051-4055.doi: 10.3969/j.issn.1673-8225.2011.22.015

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Selective posterior thoracic fusions for adolescent idiopathic scoliosis: Hooks versus pedicle screws

Fu Wei-ping1, Zhang Hai-ying2, Chu Ge3, Xiang Ze-wen3, Wang Fu-zhong4, Lu Yong5   

  1. 1Department of Orthopedics, Hospital of the Nongjiushi Division, Xinjiang Production and Construction Corps, Tacheng  834700, Xinjiang Uygur Autonomous Region, China
    2First Jikun Hospital of Xinjiang, Urumqi  830000, Xinjiang Uygur Autonomous Region, China
    3First Department of Spine, Xinjiang Hospital of Traditional Chinese Medicine, Urumqi  830000, Xinjiang Uygur Autonomous Region, China
    4Second Department of Surgery, Makit County Hospital, Kashi  844000, Xinjiang Uygur Autonomous Region, China
    5Affiliated Hospital of Traditional Chinese Medicine, Xinjiang Medical University, Xinjiang Uygur Autonomous Region, China
  • Received:2010-11-25 Revised:2011-05-10 Online:2011-05-28 Published:2011-05-28
  • Contact: Lu Yong, Chief physician, Doctoral supervisor, Associate professor, Affiliated Hospital of Traditional Chinese Medicine, Xinjiang Medical University, Xinjiang Uygur Autonomous Region, China xiaochu138@sina.com
  • About author:Fu Wei-ping, Attending physician, Department of Orthopedics, Hospital of the Nongjiushi Division, Xinjiang Production and Construction Corps, Tacheng 834700, Xinjiang Uygur Autonomous Region xiaochu138@sina.com

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Abstract:

BACKGROUND: Previous reports have documented to use hooks or pedicle screws with hooks in treating adolescent idiopathic scoliosis (AIS), or to discuss selective spinal segment for fusion.
OBJECTIVE: To compare the clinical and radiographic results of selective posterior thoracic fusion using hooks versus pedicle screws in AIS patients.
METHODS: Sixty-six consecutive patients with major thoracic-compensatory lumbar C modifier AIS curves underwent selective posterior thoracic fusion to T12 or L1 at a single institution. Hooks were used for instrumentation in 32 patients and pedicle screws were used in 34 patients. Patients were evaluated at a minimal 2-year follow-up.
RESULTS AND CONCLUSION: There was no statistical difference between the preoperative thoracic and lumbar Cobb values for the hook group versus the pedicle screw group. The amount of correction obtained surgically of the thoracic Cobb and the amount of spontaneous lumbar Cobb correction were significantly greater in the pedicle screw group (P < 0.001). The incidence of postoperative coronal decompensation, with a greater than 20 mm shift to the left of the C7 plumb line, was higher in the hook group (13 patients) as compared with the pedicle screw group (4 patients) (P < 0.005). There were no complications or reoperations in either group. Selective thoracic fusion of main thoracic-compensatory lumbar C modifier AIS curves with pedicle screws allowed better thoracic correction and less postoperative coronal decompensation than that with hooks.

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