title: Posterior spinal arthrodesis for adolescent idiopathic scoliosis using pedicle screw instrumentation: does a bilateral or unilateral screw technique affect surgical outcome?
abstract: We reviewed 212 consecutive patients with adolescent   idiopathic scoliosis who underwent posterior spinal arthrodesis   using all pedicle screw instrumentation in terms of clinical, radiological   and Scoliosis Research Society (SRS)-22 outcomes. In Group 1 (51   patients), the correction was performed over two rods using bilateral   segmental pedicle screws. In Group 2 (161 patients), the correction   was performed over one rod using unilateral segmental pedicle screws   with the second() rod providing stability of the construct   through two-level screw fixation at proximal and distal ends. The   mean age at surgery was    14.8 years in both groups. Comparison between groups showed no significant   differences with regard to age and Risser grade at surgery, pre-   and post-operative scoliosis angle, coronal Cobb correction, length   of hospital stay and SRS scores. Correction of upper thoracic curves   was significantly better in Group 1 (p = 0.02). Increased surgical time   and intra-operative blood loss was recorded in Group 1 (p < 0.001   and p = 0.04, respectively). The implant cost was reduced by mean   35% in Group 2 due to the lesser number of pedicle screws. Unilateral and bilateral pedicle screw techniques have both achieved   excellent deformity correction in adolescent patients with idiopathic   scoliosis, which was maintained at two-year follow-up. This has   been associated with high patient satisfaction and low complication   rates.
authors.affiliation: Scottish National Spine Deformity Centre, Royal Hospital For Sick Children, Sciennes Road, Edinburgh EH9 1LF, UK. atsirikos@hotmail.com
authors.forename: A I
authors.initials: AI
authors.lastname: Tsirikos
authors.forename: A S
authors.initials: AS
authors.lastname: Subramanian
mesh_terms: D000293:Adolescent; D001863:Bone Screws; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D013904:Thoracic Vertebrae / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult