Minimum 5-year follow-up results of skipped pedicle screw fixation for flexible idiopathic scoliosis: Clinical article

Abstract

Object. The aim of this study was to evaluate after more than 5 years the outcome of surgical treatment for flexible idiopathic scoliosis using skipped pedicle screw fixation. Methods. For patients with spine curves < 90° and flexibility > 20%, pedicle screws had been inserted into every other segment on the corrective side and 2-4 screws per curve had been inserted on the supportive side. The authors analyzed the results in 57 patients, including the correction rate of coronal curvature and rotational deformity, correction loss, sagittal balance, complications, blood loss, operation time, and implant costs. Results. The mean Cobb angle was 54° preoperatively and 17° immediately after surgery (69% correction). At the last follow-up, the mean Cobb angle was 18° (2% correction loss). Rotation of the apical vertebra was corrected by 50% on average and showed only a 6% correction loss at the last follow-up. None of the patients had problems in maintaining sagittal balance. An adding-on phenomenon was detected in 4 patients (7%). Twelve of 14 patients with coronal decompensation showed improvement after surgery, whereas postoperative decompensation developed in 3 patients. Four patients had implant failures, and 4 had postoperative infections. The mean blood loss during surgery was 832 ml, and the mean operation time was 167 minutes. Compared with conventional methods, the authors'method used up to 48% fewer screws. Conclusions. Skipped pedicle screw fixation of flexible idiopathic scoliosis showed satisfactory results. This method has several advantages, including reduced blood loss, shorter operation time, and reduced cost.