Influence of different instrumentation fashions on the correction results of posterior selective thoracic fusion in adolescent idiopathic scoliosis patients

Objectives To analyze the influence on the correction results of different instrumentation correction results of posterior selective thoracic fusion in adolescent idiopathic scoliosis patients.Methods We reviewed the medical records and roentgenograms of adolescent idiopathic scoliosis patients underwent selective thoracic fusion.Patients were classified into 3 group according to different instrumentations:group A:hooks-only type;group B:mixed hook and screw type;and group C:screws-only type,and the screws were used in every segment on the concave side of the thoracic curve.The parameters of the scoliosis and analyze the correction results were measured.Results There were totally 57 patients in this series(8 male and 49 female),with an average age of 14.3 years old.The average follow-up time was 19.6 months.The mean coronal Cobb angle of the thoracic curve among the 3 groups were 49.0°,48.8°,and 47.4°before surgery,and 15.1°,13.7°,and 6.8°after surgery,with an average correction rate of 62.1%,64.6%,and 79.0%.The correction rates of group B and C were significantly higher than group A(P =0.001,P =0.001),and that of group C significantly was higher than group B(P = 0.000).The mean coronal Cobb angle of the lumbar curve among the 3 groups were 32.4°,32.6°,and 35.2°,before surgery,and 12.0°,8.6°,and 8.3°after surgery,with an average correction rate of 62.3%,73.7%,and 76.6%(P =0.000).The coronal Cobb angle of the lumbar curve among the 3 groups were 16.3°,10.3°,and 11.1°,respectively,with an average correction rate of 48.9%,66.8%and 69.9%,with no significant loss(P0.05).While the correction rates of group B and C were significantly higher than that of group A(P = 0.012,P = 0.008),it was significantly higher in group C than in group B(P = 0.003).Conclusions Despite of different instrumentation selection,good correction of the thoracic curve and satisfactory spontaneous correction of the lumbar curve can be obtained in posterior selective thoracic fusion of adolescent idiopathic scoliosis.The complete pedicle screw group has the best correction results.