Comparative analysis of pedicle screw versus hybrid instrumentation in adolescent idiopathic scoliosis surgery.
BACKGROUND
Adolescent idiopathic scoliosis is the most common type of scoliosis. A Cobb angle of 50° will progress beyond the age of spinal maturity. Surgery over bracing is advised at a Cobb angle above or equal to 50°. The aim of surgery is to bring the Cobb angle down below 50° to prevent reprogression as well as improve the quality of life. The objective of the study is to analyze the efficacy and significance in lifestyle improvement of pedicle screw-only fixation system versus the more common hybrid instrumentation system used for the surgical treatment of adolescent idiopathic scoliosis.


METHODS
A prospective cohort study was conducted involving two groups of patients were included in the study. One group was operated with pedicle screw-only method while the other with hybrid instrumentation system. The pre- and post-operative Cobb's angles were taken across a follow-up of 4 years. An SRS-30 questionnaire was given in a yearly follow-up to assess the lifestyle improvement of the patient.


RESULTS
Pedicle screw-only method was significantly more effective in reducing Cobb's angle (P= 0.0487). It was showed less loss of correction (P= 0.009) pedicle screw-only surgery was also better at reducing thoracic curves (P= 0.001). There seemed a better recovery time with pedicle screw surgery (P= 0.003).


CONCLUSIONS
Pedicle screws are more effective and durable than hybrid systems at when treating adolescent idiopathic scoliosis.
Department of Surgery, Ziauddin University Hospital, Karachi, Pakistan.
Sohail
S
Rafi
Department of Surgery, Ziauddin University Hospital, Karachi, Pakistan.
Naseem
N
Munshi
Department of Surgery, Ziauddin University Hospital, Karachi, Pakistan; Department of Neurosurgery, Jinnah Postgraduate Medical Center, Karachi, Pakistan.
Asad
A
Abbas
Department of Surgery, Ziauddin University Hospital, Karachi, Pakistan.
Rabia Hassan
RH
Shaikh
Department of Surgery, Ziauddin University Hospital, Karachi, Pakistan.
Imtiaz
I
Hashmi
Adolescent idiopathic scoliosis; hybrid instrumentation system; pedicle screws
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