Segmental correction of adolescent idiopathic scoliosis by all-screw fixation method in adolescents and young adults. minimum 5 years follow-up with SF-36 questionnaire

Forty-nine consecutive patients were retrospectively 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.The average major curve was corrected from 58.0 ± 13.0° Preop to 16.0 ± 9.0° PO(p < 0.0001), and increased to 18.4 ± 8.6°(p = 0.12) 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 = 0.25)). 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 and role physical.Follow-up more than 5 years, the authors suggest that all-screw method is an efficient and safe method.In the past decade, pedicle screws have become the mainstream of the fixation method used to correct spinal deformities. Surgical treatment of adolescent idiopathic scoliosis (AIS) with an all-screw method has also proven to be a effective and safe procedure [1-3].Compared with other spinal fixation devises, pedicle screws have greater correction power because of their three-column fixation [4,5]. In our experience, the use of the all-screw method achieves a superior three-dimensional curve correction rate than the two previous methods: the all-hook method and hook/screw hybrid method [6,7] Additionally, more motion segments could be saved by reduction of the fusion length in thoracic scoliosis [1]. However, the insertion of pedicle screws in the thoracic spine is always a safety concern, especially in the upper thoracic area because of small pedicle calibers, close