• R Shay Bess, Lawrence G Lenke, Keith H Bridwell, Gene Cheh, Stephen Mandel, and Brenda Sides.
• Department of Orthopaedic Surgery, Washington University Medical Center, St. Louis, MO 63110, USA.
• Spine. 2007 Mar 1; 32 (5): 555-61.

Study DesignRetrospective, case-control, matched cohort.ObjectiveCompare the radiographic and clinical outcomes of adult spinal deformity patients treated with thoracic pedicle screw (TPS) or thoracic hook constructs.Summary Of Background DataThe efficacy of TPS instrumentation for pediatric spinal deformity correction has been established. Little is known about TPS use in adult spinal deformity.MethodsFifty-six patients (average age, 49 years; average follow-up, 3.58 years) were treated with TPS or thoracic hook constructs for coronal (n = 20) or sagittal (n = 36) plane deformities. Patients were evaluated radiographically and with SRS scores.ResultsCoronal deformities treated with TPS demonstrated improved main thoracic curve correction compared with hook constructs at last follow-up (24.8 degrees vs. 13.8 degrees; P < 0.05), despite having larger (59.8 degrees vs. 44.9 degrees; P < 0.05) and more rigid preoperative curves (29.3% vs. 44.9% correction on side-bending radiographs; P < 0.001). Sagittal deformities treated with TPS constructs demonstrated greater thoracolumbar kyphosis correction than hook constructs at last follow-up (12.1 degrees vs. 2.5 degrees; P < 0.05). No TPS patient had a thoracic pseudarthrosis. Four hook patients (14%) had thoracic pseudarthroses.ConclusionsTPS instrumentation allows greater coronal and sagittal plane correction and may reduce the risk of thoracic pseudarthrosis compared with hook constructs when treating adult spinal deformities.

34 keywords...

hide…