J Korean Orthop Assoc.  2019 Apr;54(2):141-149. 10.4055/jkoa.2019.54.2.141.

Correction of Single Thoracic Adolescent Idiopathic Scoliosis Using Pedicle Screw Instrumentation: Comparison of Stainless Steel to Titanium Alloy Instruments

Affiliations
  • 1Department of Orthopedic Surgery, Inje University Haeundae Paik Hospital, Busan, Korea.
  • 2Department of Orthopedic Surgery, Inje University Sanggye Paik Hospital, Seoul, Korea. scd25@paik.ac.kr
  • 3Department of Orthopedic Surgery, Inje University Ilsan Paik Hospital, Goyang, Korea.

Abstract

PURPOSE
To compare the results of two different instruments made of stainless steel and titanium alloy for correction of single thoracic adolescent idiopathic scoliosis (AIS) using pedicle screw instrumentation.
MATERIALS AND METHODS
A total of 141 patients with single thoracic AIS treated with pedicle screw instrumentation and selective thoracic fusion were retrospectively reviewed after a follow-up of 2 years. The patients had a main thoracic curve of 40° to 75° and were divided into two groups based on instrument materials; S group (stainless steel, n=90) and T group (titanium alloy, n=51). The diameter of the stainless steel rod used was 7.0 mm while that of the titanium alloy rod was 6.35 mm or 6.0 mm. Standing long-cassette radiographic measurements including various coronal and sagittal parameters for the preoperative, early postoperative and 2-year postoperative follow-up were analyzed. There were no significant differences in the preoperative curve characteristics between the two groups.
RESULTS
In the S group, the preoperative main thoracic curve of 51.3°±8.4° was improved to 19.0°±7.6° (63.1% correction) and the lumbar curve of 32.3°±8.4° spontaneously decreased to 12.7°±8.2° (62.9% correction) at 2 years postoperatively. In the T group, the preoperative main thoracic curve of 49.5°±8.4° and the lumbar curve of 30.3°±8.9° was improved to 18.8°±7.4° (62.2% correction) and 11.3°±5.4° (63.3% correction), respectively. The corrections of coronal curves were not statistically different between the two groups (p>0.05). The thoracic kyphosis was changed from 16.8°±8.5° to 24.3°±6.1° in the S group and from 19.6°±11.2° to 26.6°±8.5° in the T group. There were no significant differences in the changes of sagittal curves, coronal and sagittal balances at the 2-year follow-up and the number of fused segments and used screws between the two groups (p>0.05).
CONCLUSION
When conducting surgery for single thoracic AIS using pedicles screw instrumentation, two different instruments made of stainless steel and titanium alloy showed similar corrections for coronal and sagittal curves.

Keyword

scoliosis; adolescent; pedicle screws; stainless steel; titanium
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