Adolescent idiopathic scoliosis (AIS) treated with arthrodesis and posterior titanium instrumentation: 8 to 12 years follow up without late infection.
BACKGROUND
There are no data in the peer-reviewed literature regarding long term results in patients treated for AIS with a posterior titanium instrumentation. Therefore we assessed the outcome in 50 patients treated by titanium implant.


METHODS
A total of 50 patients with a mean age of 16.6 years were treated. In all patients, titanium hooks and pedicle screws were used in combination. The demographic data and the pre- and post-operative radiographs of all 50 patients were re-examined, and 49 of the 50 patients (98%) attended a radiological and clinical follow up-examination on average 10.1 years post-operatively. The clinical results were recorded by means of the SRS 24 questionnaire.


RESULTS
In the frontal plane, the mean pre-operative thoracic and lumbar curve had been 62.4 degrees and 43.5 degrees respectively, post-operatively the curves were reduced to 26.9 degrees and 16.3 degrees , resulting in a correction rate of 56.9% for thoracic and 62.5% for lumbar curve. At the follow up-evaluation, the Cobb angle of the thoracic and lumbar curve was 31.0 degrees and 21.3 degrees respectively, giving a final correction rate of 50.3% for thoracic, and 51.0% for lumbar curve. 7 of the 50 patients (14.3%) had undergo revision surgery for complications, but complete implant removal was necessary in only one case. Analysis of the SRS 24 questionnaire showed an average score of 95.8 points.


CONCLUSIONS
Posterior titanium instrumentation is a safe and effective procedure in the surgical correction of AIS. In this retrospective study with small patient number, it shows favourable long-term results; in particular, the loss of correction is low, no late infection occurred and there was a very high survival rate of the implant itself.
Mueller
Franz J
FJ
Department of Spinal Surgery and Scoliosis Center, Behandlungszentrum Vogtareuth, Germany. muellerfj5@aol.com
Gluch
Herbert
H
Spine (Phila Pa 1976). 1995 Jul 15;20(14):1575-84
7570172
J Orthop Res. 2004 Jan;22(1):39-43
14656657
Spine (Phila Pa 1976). 1989 Mar;14(3):275-80
2711242
Eur Spine J. 2003 Aug;12(4):435-9
12827472
J Spinal Disord. 1998 Oct;11(5):440-3
9811105
Eur Spine J. 1995;4(5):280-3
8581528
J Bone Joint Surg Am. 1962 Jun;44-A:591-610
14036052
J Bone Joint Surg Am. 1995 Apr;77(4):524-9
7713968
Eur Spine J. 2000 Jun;9(3):191-7
10905435
Biomaterials. 1995 Nov;16(16):1273-7
8589199
Eur Spine J. 2005 Oct;14(8):783-8
15841406
Spine (Phila Pa 1976). 2004 Sep 15;29(18):2013-23
15371702
Spine (Phila Pa 1976). 2001 Jun 1;26(11):1268-73
11389396
Spine (Phila Pa 1976). 1999 Sep 15;24(18):1909-12
10515015
Biomaterials. 1989 Jul;10(5):325-8
2765629
J Bone Joint Surg Am. 2003 Dec;85(12):2303-9
14668498
Rev Chir Orthop Reparatrice Appar Mot. 1984;70(6):489-94
6239334
Spine (Phila Pa 1976). 2004 Sep 15;29(18):2024-30
15371703
Spine (Phila Pa 1976). 2000 Feb 15;25(4):463-8
10707392
Spine (Phila Pa 1976). 2002 Sep 15;27(18):2046-51
12634567
J Bone Joint Surg Am. 1983 Dec;65(9):1302-13
6654943
J Bone Joint Surg Am. 1995 Aug;77(8):1210-6
7642667
Spine (Phila Pa 1976). 2004 Feb 15;29(4):398-404
15094536