Implant and spinal mobility influence on the spinal curvature correction in adolescent idiopathic Lenke I type scoliosis ; Implantų ir stuburo mobilumo įtaka stuburo iškrypimo korekcijai sergant jaunatvine idiopatine I tipo Lenke skolioze

Background and objective There are still a few researches accomplished to evaluate the advantages and disadvantages of screw, hybrid, and hook techniques in the treatment of adolescent idiopathic scoliosis. As the results are controversial, researchers still look for optimally safe, least traumatizing and economically reasonable methods to treat spinal deformities. The aim of this study is to analyze postoperative spine deformity correction results for Lenke type 1 dependent on fixation type and preoperative bending films. Patients and methods A retrospective study was performed. Patients admitted to the Children’s Hospital, Affiliate of Vilnius University Hospital Santariskiu Klinikos Orthopedic Department in the period of 1994–2013 were included; 74 cases were analyzed. Three groups according to spine implants were generated. The first included patients treated with pedicle screw fixation, the second – hybrid, and the third – hook fixation. Inclusion criteria: the adolescent age group (10–18), idiopathic scoliosis Lenke I type who undergone posterior spinal fusion with pedicle screws; hybrid fixation and hook application were evaluated in order to compare curve correction dependence on fixation type and curve flexibility. Thoracic and lumbar curve measurements on the coronal plane were performed using the Cobb technique applied on anterior posterior radiographs taken before and two days after surgery. Also, to measure curve flexibility, preoperative passive standing bending films were analyzed. Curve degrees in preoperative passive bending films were compared with the remaining postoperative spinal curves in groups separately. The remaining postoperative curves were compared respectively. Results In total, 74 cases met the inclusion criteria, of them 67 (90.50%) girls and 7 (9.50%) boys. The mean preoperative thoracic Cobb angle was 51.07º (±6.20) in the screw group, 52.88º (±7.26) in the hybrid and 55.45º (±10.94) in the hook group. To compare the preoperative stiffness of the curves, the flexibility % was ...