Objective: The purpose of this study was to compare pedicle screw fixation (PSF) with hybrid instrumentation (HI) in cases of adolescent idiopathic scoliosis (AIS).Methods: Thirty-eight patients with AIS who underwent PSF (n=19) or HI (n=19) between 2001 and 2011 were retrospectively reviewed. Patients had similar age at surgery and similar number of fused vertebrae. Operative time, intraoperative blood loss, and postoperative complications were compared between the 2 groups. Spinal radiographs for apical vertebral translation, global coronal balance, major curve Cobb angle, global sagittal balance, thoracic kyphosis, and lumbar lordosis were measured in all patients preoperatively and at 2-year follow-up; the results were then compared between the 2 groups. Postoperative correction was calculated for all patients and compared between the 2 groups.Results: The average time of surgery ofthe PSF group was significantly longer than that of the HI group (p<0.05). The amount of bleeding of the PSF group was significantly higher than the HI group (p<0.01). No statistically significant difference was found between the groups in respect to the development of complications (p>0.05). Both the major curve Cobb angle and the global sagittal balance showed greater improvement in the PSF group compared to the HI group (p<0.01). Postoperative correction was better in the PSF group than the HI group.Conclusion: The PSF system provided better improvement than the HI system in major curve Cobb angle and global sagittal balance, and postoperative correction was better in the PSF group than the HI group.
___
Kim YJ, Lenke LG, Cho SK, Bridwell KH, Sides B, Blanke K. Comparative analysis of pedicle screw versus hook in- strumentation in posterior spinal fusion of adolescent idio- pathic scoliosis. Spine (Phila Pa 1976) 2004;29:2040-8.
Asghar J, Samdani AF, Pahys JM, D'andrea LP, Guille JT, Clements DH, et al. Computed tomography evaluation of rotation correction in adolescent idiopathic scoliosis: a comparison of an all pedicle screw construct versus a hook- rod system. Spine (Phila Pa 1976) 2009;34:804-7.
Crawford AH, Lykissas MG, Gao X, Eismann E, Anadio J. All-pedicle screw versus hybrid instrumentation in ado- lescent idiopathic scoliosis surgery: a comparative radio- graphical study with a minimum 2-Year follow-up. Spine (Phila Pa 1976) 2013;38:1199-208.
Kim YJ, Lenke LG, Kim J, Bridwell KH, Cho SK, Cheh G, et al. Comparative analysis of pedicle screw versus hybrid instrumentation in posterior spinal fusion of adolescent id- iopathic scoliosis. Spine (Phila Pa 1976) 2006;31:291-8.
Lowenstein JE, Matsumoto H, Vitale MG, Weidenbaum M, Gomez JA, Lee FY, et al. Coronal and sagittal plane cor- rection in adolescent idiopathic scoliosis: a comparison be- tween all pedicle screw versus hybrid thoracic hook lumbar screw constructs. Spine (Phila Pa 1976) 2007;32:448-52.
Di Silvestre M, Bakaloudis G, Lolli F, Vommaro F, Mar- tikos K, Parisini P. Posterior fusion only for thoracic adolescent idiopathic scoliosis of more than 80 degrees: pedicle screws versus hybrid instrumentation. Eur Spine J 2008;17:1336-49.
Karatoprak O, Unay K, Tezer M, Ozturk C, Aydogan M, Mirzanli C. Comparative analysis of pedicle screw versus hybrid instrumentation in adolescent idiopathic scoliosis surgery. Int Orthop 2008;32:523-9.
Lee SM, Suk SI, Chung ER. Direct vertebral rotation: a new technique of three-dimensional deformity correction with segmental pedicle screw fixation in adolescent idio- pathic scoliosis. Spine (Phila Pa 1976) 2004;29:343-9.
Yilmaz G, Borkhuu B, Dhawale AA, Oto M, Littleton AG, Mason DE, et al. Comparative analysis of hook, hybrid, and pedicle screw instrumentation in the posterior treat- ment of adolescent idiopathic scoliosis. J Pediatr Orthop 2012;32:490-9.
Sugarman E, Sarwahi V, Amaral T, Wollowick A, Gam- bassi M, Seimon L. Comparative analysis of perioperative differences between hybrid versus pedicle screw instru- mentation in adolescent idiopathic scoliosis. J Spinal Dis- ord Tech 2013;26:161-6.
Rose PS, Lenke LG, Bridwell KH, Mulconrey DS, Cronen GA, Buchowski JM, et al. Pedicle screw instrumentation for adult idiopathic scoliosis: an improvement over hook/ hybrid fixation. Spine (Phila Pa 1976) 2009;34:852-8.
Suk SI, Lee SM, Chung ER, Kim JH, Kim SS. Selective thoracic fusion with segmental pedicle screw fixation in the treatment of thoracic idiopathic scoliosis: more than 5-year follow-up. Spine (Phila Pa 1976) 2005;30:1602-9.
Lenke LG, Betz RR, Harms J, Bridwell KH, Clements DH, Lowe TG, et al. Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis. J Bone Joint Surg Am 2001;83-A:1169-81.
Jaquith BP, Chase A, Flinn P, Sawyer JR, Warner WC, Freeman BL, et al. Screws versus hooks: implant cost and deformity correction in adolescent idiopathic scoliosis. J Child Orthop 2012;6:137-43.
Lehman RA Jr, Lenke LG, Keeler KA, Kim YJ, Buchowski JM, Cheh G, et al. Operative treatment of adolescent id- iopathic scoliosis with posterior pedicle screw-only con- structs: minimum three-year follow-up of one hundred fourteen cases. Spine (Phila Pa 1976) 2008;33:1598-604.
Liljenqvist U, Lepsien U, Hackenberg L, Niemeyer T, Halm H. Comparative analysis of pedicle screw and hook instrumentation in posterior correction and fusion of idio- pathic thoracic scoliosis. Eur Spine J 2002;11:336-43.