title: Comparison of Consecutive, Interval, and Skipped Pedicle Screw Techniques in Moderate Lenke Type 1 Adolescent Idiopathic Scoliosis.
abstract: OBJECTIVE
  To compare perioperative, radiographic, and Scoliosis Research Society-22 (SRS-22) outcomes of consecutive, interval, and skipped pedicle screw techniques in patients with moderate Lenke type 1 adolescent idiopathic scoliosis (AIS).
  
  
  METHODS
  We retrospectively reviewed 65 consecutive moderate Lenke type 1 AIS patients at a single institution using all-pedicle screw constructs, with a minimum of 2 years of follow-up. In the consecutive group (C group, n = 22), pedicle screws were instrumented at consecutive levels bilaterally. In the interval group (I group, n = 18), pedicle screws were placed at every level on the concave side while skipping levels on the convex side. In the skipped group (S group, n = 25), pedicle screws were instrumented by skipping levels bilaterally. Perioperative, radiographic, and SRS-22 measurements were analyzed with a 1-way analysis of variance.
  
  
  RESULTS
  No significant differences were found in length of hospital stay, fused levels, coronal correction, and SRS-22 scores among the 3 groups. Increased surgery time was found in the C group compared with the I and S groups (P = 0.001 and P = 0.005, respectively). Decreased blood loss and blood transfusions were found in the S group compared with the C group (P = 0.04 and P = 0.047, respectively). Decreased implant costs were found in the S group compared with the C and I groups (P < 0.001 and P = 0.03, respectively).
  
  
  CONCLUSIONS
  Consecutive, interval, and skipped pedicle screw techniques all provide satisfactory deformity correction and SRS-22 outcomes with few complications. With better perioperative outcomes, interval and skipped pedicle screw techniques are the more cost-effective options for patients with moderate Lenke type 1 AIS.
authors.affiliation: Institute of Spinal Deformity, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, P. R. China.
authors.forename: Ming
authors.initials: M
authors.lastname: Luo
authors.affiliation: Institute of Spinal Deformity, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, P. R. China.
authors.forename: Mingkui
authors.initials: M
authors.lastname: Shen
authors.affiliation: Institute of Spinal Deformity, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, P. R. China.
authors.forename: Wengang
authors.initials: W
authors.lastname: Wang
authors.affiliation: Institute of Spinal Deformity, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, P. R. China. Electronic address: xialeigu1@126.com.
authors.forename: Lei
authors.initials: L
authors.lastname: Xia
mesh_terms: D000293:Adolescent; D016063:Blood Loss, Surgical; D001803:Blood Transfusion / Q000706:statistics & numerical data; D002648:Child; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D019300:Medical Errors; D065289:Pedicle Screws; D011859:Radiography; D012189:Retrospective Studies; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome
keywords: Adolescent idiopathic scoliosis; Consecutive pedicle screw; Interval pedicle screw; Skipped pedicle screw