Comparison of thoracic pedicle screw to hook instrumentation for the treatment of adult spinal deformity.

Abstract:

STUDY DESIGN:Retrospective, case-control, matched cohort. OBJECTIVE:Compare the radiographic and clinical outcomes of adult spinal deformity patients treated with thoracic pedicle screw (TPS) or thoracic hook constructs. SUMMARY OF BACKGROUND DATA:The efficacy of TPS instrumentation for pediatric spinal deformity correction has been established. Little is known about TPS use in adult spinal deformity. METHODS:Fifty-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. RESULTS:Coronal 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. CONCLUSIONS:TPS 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.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Bess RS,Lenke LG,Bridwell KH,Cheh G,Mandel S,Sides B

doi

10.1097/01.brs.0000256445.31653.0e

subject

Has Abstract

pub_date

2007-03-01 00:00:00

pages

555-61

issue

5

eissn

0362-2436

issn

1528-1159

pii

00007632-200703010-00010

journal_volume

32

pub_type

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