title: Effectiveness and safety of posterior titanium instrumentation in children with adolescent idiopathic scoliosis: a prospective study.
abstract: OBJECTIVE
  This study aims to determine the effectiveness and the relative safety of posterior spinal fusion with titanium instrumentation in children with adolescent idiopathic scoliosis (AIS).
  
  
  METHODS
  A prospective cohort (case-only) study was conducted to determine this effectiveness and safety. There were 24 patients (21 girls, 3 boys; mean age 14.1±1.8 years; range 11 to 17 years) who underwent surgery between January 2002 and December 2003 in our clinic, with a minimum of two years follow-up. Upper thoracic, thoracic, and thoracolumbar coronal curves as well as kyphosis from T5-T12 were measured as main outcome variables and repeated measure ANOVA was used to assess the data.
  
  
  RESULTS
  The main thoracic curve (coronal plane) correction achieved at the first erect period (the first 4 weeks postoperative) (mean 12.21±9.78 degrees), this correction was maintained at 24 months follow-up (mean 15.71±7.15 degrees) and both were significantly lower than the preoperative values (mean 57.0±12.75 degrees), (p<0.001). Sagittal plane (kyphosis angle between T5-T12) curve was not worsened by posterior titanium instrumentation and it was 19.50±10.53 degrees preoperatively, 16.45±6.68 degrees at the first erect period and 17.73±8.40 degrees at the 24 months follow-up (p=0.74). There were no evidence of pseudoarthrosis, no loss of correction and no infections.
  
  
  CONCLUSIONS
  Posterior titanium instrumentation in the treatment of AIS is effective due to its ability to achieve and maintain curve correction. Further, this instrumentation does not worsen hypokyphosis and is safe since there were no adverse events.
authors.affiliation: Department of Orthopedics, Nemours AI DuPont Hospital for Children, Wilmington, DE 19803, USA.
authors.forename: Murat
authors.initials: M
authors.lastname: Oto
authors.forename: Suken A
authors.initials: SA
authors.lastname: Shah
authors.forename: Mohammed Ali Hassan
authors.initials: MA
authors.lastname: Mohammed
authors.forename: Kenny J
authors.initials: KJ
authors.lastname: Rogers
authors.forename: Petya
authors.initials: P
authors.lastname: Yorgova
authors.forename: Laurens
authors.initials: L
authors.lastname: Holmes
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D011446:Prospective Studies; D011859:Radiography; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation*; D013904:Thoracic Vertebrae / Q000601:surgery; D014025:Titanium; D016896:Treatment Outcome
chemical_list: D014025:Titanium