Egyptian Spine Journal (Apr 2012)
Segmental Derotation Using Alternating Pedicular Screws in Treatment of Adolescent Idiopathic Scoliosis
Abstract
Background Data: The use of pedicle screw implants for the treatment of Adolescent Idiopathic Scoliosis (AIS) has gained popularity over the past several years. Pedicle screws have been shown to be safe and effective in the treatment of AIS as well as having greater correction power in the coronal, sagittal, and axial planes over hybrid constructs. Purpose: To assess the effectiveness and safety of segmental derotation using alternative posterior segmental fixation in managing adolescent idiopathic scoliosis. Study Design: A prospective clinical study enrolled 26 patients with adolescent idiopathic scoliosis who were treated by segmental derotation using alternative posterior segmental fixation. The study was done from January 2005 till july 2009. Methods: This study enrolled 26 patients with an average age of 15 yrs. All patients had a preoperative assessment by physical examination, plain radiography (anteroposterior,lateral, dynamic views). Scoliotic curves had a mean preoperative value of 67.2o. All patients underwent segmental derotation using alternating posterior segmental fixation under general anesthesia. Average follow up was 32.6 months and was done on regular basis; immediately postoperatively then at 4 weeks and regularly every 3 months by clinical and plain x-ray radiography. Measurements were done using Image Luncher 1.4.3.67 software. Statistical analysis was done by SPSS13.0 for windows software. Results: All patients showed marked postoperative improvement of their scoliotic deformities. Mean scoliotic curves improved from 67.2o to 10.6°. Radiographic assessment revealed 100% fusion with no loss of correction. Postoperative recovery was fast with ambulation on the second postoperative day. No complications were accounted. Conclusion: Segmental derotation using alternative pedicular fixation in managing adolescent idiopathic scoliosis provides an effective method of correcting scoliotic curves. This method provides excellent scoliotic curve correction with no loss of correction, better fusion rates, rapid postoperative recovery, and decreased complications. (2012ESJ013)
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