Titanium vs cobalt chromium: what is the best rod material to enhance adolescent idiopathic scoliosis correction with sublaminar bands?
Cobalt chromium (CoCr) rods have recently gained popularity in adolescent idiopathic scoliosis (AIS) surgical treatment, replacing titanium (Ti) rods, with promising frontal correction rates in all-screw constructs. Posteromedial translation has been shown to emphasize thoracic sagittal correction, but the influence of rod material in this correction technique has never been investigated. The aim of this study was to compare the postoperative correction between Ti and CoCr rods for the treatment of thoracic AIS using posteromedial translation technique.



70 patients operated for thoracic (Lenke 1 or 2) AIS, in 2 institutions, between 2010 and 2013, were included. All patients underwent posterior fusion with hybrid constructs using posteromedial translation technique. The only difference between groups in the surgical procedure was the rod material (Ti or CoCr rods). Radiological measurements were compared preoperatively, postoperatively and at last follow-up (minimum 2 years).



Preoperatively, groups were similar in terms of coronal and sagittal parameters. Postoperatively, no significant difference was observed between Ti and CoCr regarding frontal corrections, even when the preoperative flexibility of the curves was taken into account (p = 0.13). CoCr rods allowed greater restoration of T4T12 thoracic kyphosis, which remained stable over time (p = 0.01). Most common postoperative complication was proximal junctional kyphosis (n = 4). However, no significant difference was found between groups regarding postoperative complications rate.



CoCr and Ti rods both provide significant and stable frontal correction in AIS treated with posteromedial translation technique using hybrid constructs. However, CoCr might be considered to emphasize sagittal correction in hypokyphotic patients.
Department of Paediatric Orthopaedics, Robert Debré Hospital, Paris Diderot University, 48 Boulevard Sérurier, 75019, Paris, France. angelliaume.audrey@gmail.com.
Audrey
A
Angelliaume
Department of Paediatric Orthopaedics, Robert Debré Hospital, Paris Diderot University, 48 Boulevard Sérurier, 75019, Paris, France.
E
E
Ferrero
Department of Paediatric Orthopaedics, Robert Debré Hospital, Paris Diderot University, 48 Boulevard Sérurier, 75019, Paris, France.
K
K
Mazda
Department of Paediatric Orthopaedics, Robert Debré Hospital, Paris Diderot University, 48 Boulevard Sérurier, 75019, Paris, France.
M
M
Le Hanneur
Department of Paediatric Orthopaedics, Purpan University Hospital, Place du Docteur Baylac, 31059, Toulouse, France.
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F
Accabled
Department of Paediatric Orthopaedics, Purpan University Hospital, Place du Docteur Baylac, 31059, Toulouse, France.
J Sales
JS
de Gauzy
Department of Paediatric Orthopaedics, Robert Debré Hospital, Paris Diderot University, 48 Boulevard Sérurier, 75019, Paris, France.
B
B
Ilharreborde
D000293:Adolescent; D001858:Bone Nails; D002858:Chromium Alloys; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D012189:Retrospective Studies; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation*; D013904:Thoracic Vertebrae / Q000601:surgery; D014025:Titanium
D002858:Chromium Alloys; D014025:Titanium
Adolescent idiopathic scoliosis; Cobalt–chromium rods; Hypokyphosis; Posteromedial translation; Sublaminar bands