title: Five-year clinical and radiographic outcomes using pedicle screw only constructs in the treatment of adolescent idiopathic scoliosis.
abstract: OBJECTIVE
  To determine the mid-term clinical and radiographic impact of pedicle screw fixation in patients with adolescent idiopathic scoliosis (AIS).
  
  
  METHODS
  A multicenter AIS database was retrospectively queried to identify 99 consecutive patients who underwent posterior spinal fusion using an all pedicle screw construct with a minimum of 5-year follow-up. Radiographic and clinical parameters were reviewed at regular intervals up to 5 years.
  
  
  RESULTS
  The mean age was 14.4 ± 2.0 years with 79 % being female. The mean preoperative major curve was 51.7 ± 14.2° with a mean correction of 66 and 64 % at 2 and 5 years (p = 0.16). Pre-op thoracic kyphosis averaged 22.3 ± 12.9° and was 18.4 ± 10.6° at 5 years with no significant change from 2 years (p = 0.33). SRS total and domain scores demonstrated significant improvements at 2 years, which were slightly decreased at 5 years (p = 0.06). SRS scores of self-image (p = 0.99) and satisfaction (p = 0.18) were significantly improved after surgery with minimal change by 5 years. The change in SRS total scores from 2 to 5 years was attributed to differences in SRS scores of pain and mental health (p < 0.05).
  
  
  CONCLUSIONS
  Intermediate follow-up of patients with AIS treated with an all pedicle screw construct demonstrates maintenance of their coronal, and sagittal plane correction between 2- and 5-year follow-up. At 5 years, improvements in SRS scores were consistent with 2-year values, except for a decline in pain and mental health scores.
authors.affiliation: Tufts Medical Center, Floating Hospital for Children, Boston, MA, USA.
authors.forename: Steven W
authors.initials: SW
authors.lastname: Hwang
authors.forename: Amer F
authors.initials: AF
authors.lastname: Samdani
authors.forename: Michelle
authors.initials: M
authors.lastname: Marks
authors.forename: Tracy
authors.initials: T
authors.lastname: Bastrom
authors.forename: Hitesh
authors.initials: H
authors.lastname: Garg
authors.forename: Baron
authors.initials: B
authors.lastname: Lonner
authors.forename: James T
authors.initials: JT
authors.lastname: Bennett
authors.forename: Joshua
authors.initials: J
authors.lastname: Pahys
authors.forename: Suken
authors.initials: S
authors.lastname: Shah
authors.forename: Firoz
authors.initials: F
authors.lastname: Miyanji
authors.forename: Harry
authors.initials: H
authors.lastname: Shufflebarger
authors.forename: Peter
authors.initials: P
authors.lastname: Newton
authors.forename: Randal
authors.initials: R
authors.lastname: Betz
mesh_terms: D000293:Adolescent; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011859:Radiography; D012189:Retrospective Studies; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome