title: Segmental correction of adolescent idiopathic scoliosis by all-screw fixation method in adolescents and young adults. minimum 5 years follow-up with SF-36 questionnaire.
abstract: BACKGROUND
  In our institution, the fixation technique in treating idiopathic scoliosis was shifted from hybrid fixation to the all-screw method beginning in 2000. We conducted this study to assess the intermediate -term outcome of all-screw method in treating adolescent idiopathic scoliosis (AIS).
  
  
  METHODS
  Forty-nine consecutive patients were retrospectively included with minimum of 5-year follow-up (mean, 6.1; range, 5.1-7.3 years). The average age of surgery was 18.5 ± 5.0 years. We assessed radiographic measurements at preoperative (Preop), postoperative (PO) and final follow-up (FFU) period. Curve correction rate, correction loss rate, complications, accuracy of pedicle screws and SF-36 scores were analyzed.
  
  
  RESULTS
  The average major curve was corrected from 58.0 ± 13.0° Preop to 16.0 ± 9.0° PO(p < 0.0001), and increased to 18.4 ± 8.6°(p = 0.12) FFU. This revealed a 72.7% correction rate and a correction loss of 2.4° (3.92%). The thoracic kyphosis decreased little at FFU (22 ± 12° to 20 ± 6°, (p = 0.25)). Apical vertebral rotation decreased from 2.1 ± 0.8 PreOP to 0.8 ± 0.8 at FFU (Nash-Moe grading, p < 0.01). Among total 831 pedicle screws, 56 (6.7%) were found to be malpositioned. Compared with 2069 age-matched Taiwanese, SF-36 scores showed inferior result in 2 variables: physical function and role physical.
  
  
  CONCLUSIONS
  Follow-up more than 5 years, the authors suggest that all-screw method is an efficient and safe method.
authors.affiliation: Department of Orthopaedic Surgery, National Taiwan University Hospital, No, 7, Chung San South Road, Taipei 100, Taiwan. pqchen@ccms.ntu.edu.tw.
authors.forename: Ching-Hsiao
authors.initials: CH
authors.lastname: Yu
authors.forename: Po-Quang
authors.initials: PQ
authors.lastname: Chen
authors.forename: Shu-Chuang
authors.initials: SC
authors.lastname: Ma
authors.forename: Chee-Huan
authors.initials: CH
authors.lastname: Pan