• Xian-Zhao Wei, Xiao-Yi Zhou, Yi-Lin Yang, Xi-Ming Xu, Jing-Feng Li, Yu-Shu Bai, Xiao-Dong Zhu, Ming Li, and Fei Wang.
• Department of Orthopaedic Surgery, the Affiliated Changhai Hospital of the Second Military Medical University, Shanghai, China.
• Spine. 2017 Aug 15; 42 (16): 1226-1232.

Study DesignA retrospective clinical and radiographic study.ObjectiveThe aim of this study was to evaluate outcomes of the key vertebral pedicle screw strategy (KVPSS) for the correction of flexible Lenke type 1 adolescent idiopathic scoliosis (AIS) with a minimum follow-up of 5 years.Summary Of Background DataThe KVPSS has been described as an alternative screw placement strategy for surgically treating the main thoracic curve in AIS patients. However, there have been no long-term, three-dimensional correction studies of selective thoracic fusion using the KVPSS in Lenke type 1AIS.MethodTwenty consecutive patients with Lenke type 1 main thoracic AIS underwent one-stage posterior correction and fusion using the KVPSS. Preoperative and postoperative radiographic and clinical parameters were analyzed.ResultsThe mean preoperative major thoracic curve was 47.4° ± 5.8°, and mean corrections of 67.0%, 63.4%, and 61.5% were observed at the immediate, 2-year postoperative, and final follow-ups, respectively. Thoracickyphosis decreased significantly from the preoperative period to the immediate postoperative period (P = 0.042) but did not change significantly from the 2-year postoperative follow-up to the final follow-up (P = 0.067). Apical vertebral rotation achieved 34.7% correction and exhibited correction loss of 8.2% at the final follow-up. The average intraoperative blood loss was 802.3 mL, and the mean operative time was 138.6 minutes. SRS-22 scores for self-image and satisfaction improved significantly from the preoperative period to the final follow-up. No neurologic or implant-associated complications were observed in this study.ConclusionThe KVPSS is an effective method for correcting Lenke type 1 AIS and achieves satisfactory correction of the deformity. Relative to other approaches, the KVPSS can not only achieve a satisfactory and cost-effective clinical outcome but also reduce both operative time and intraoperative blood loss.Level Of Evidence4.

27 keywords...

hide…