Summary: Forty‐nine AIS patients, treated with posterior fusion using all‐screw method showed a satisfactory radiographic and clinical results without major complications with more than 5‐year‐followup. Functional outcome assessed by the SF‐36 questrionnaire showed some physical limitation compared to normal populations. The author suggest all‐screw method is a effective and safe method. Besides, the study also revealed a similar deformity correction results between adolescents and young adults.
Introduction: In last decade, pedicel screws have become the mainstream of the fixation method for spinal deformity correction. All‐screw method has also been proved to be a effective and safe procedure in recent years.
Methods: Forty‐nine consecutive patients were included with minimum of 5‐ year follow‐up (mean, 6.1; range, 5.1‐7.3 years). The average age of surgery was 18.5 ± 5.0 years. We assessed radiographic measurements at preoperative (Preop), postoperative (PO) and final follow‐up (FFU) period. Curve correction rate, correction loss rate, complications, accuracy of pedicle screws and SF‐36 scores were analyzed. Two age groups was divided depending on age of surgery and their results were also compared: the adolescent (AIS) group (≤ 20 years, n=34) and the young adult (ADIS) group (> 20 years, n=15)
Results: The average major curve was corrected from 58.0 ± 13.0° Preop to 16.0 ± 9.0° PO, and increased to 18.4 ± 8.6° (p>0.05) FFU. This revealed a 72.7% correction rate and a correction loss of 2.4° (3.92%). The thoracic kyphosis decreased little at FFU (22 ± 12° to 20 ± 6°, p>0.05). Apical vertebral rotation decreased from 2.1 ± 0.8 PreOP to 0.8 ± 0.8 at FFU (Nash‐Moe grading, p<0.01). Among total 831 pedicle screws, 56 (6.7%) were found to be malpositioned. Compared with 2069 age‐matched Taiwanese, SF‐36 scores showed inferior result in 2 variables: physical function (81.94 versus 96.82) and role physical (61.29 versus 89.63). No fatal or neurological complications were noted except one postoperative hemothorax. The deformity correction was similar between AIS and ADIS group.
Conclusion: Follow‐up more than 5 years, the authors suggest that all‐screw method is an efficient and safe method. The results between adolescents and young adults was comparable.