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SP8: HOOKS OR SCREWS – WHICH IS BEST FOR AIS? A STUDY OF FIXATION TECHNIQUES FOR ADOLESCENT IDIOPATHIC SCOLIOSIS



Abstract

Introduction: Studies suggest pedicle screw constructs are more effective than hybrid or hook constructs for AIS correction. This study assessed the efficacy of three methods of spinal instrumentation in patients treated at the WCH.

Methodology: 30 AIS patients who underwent posterior spinal surgery were matched according to age, fusion levels, and Lenke curve. Three constructs were assessed, hook-exclusive, screw-exclusive and hybrid constructs, with 10 patients in each group. Endpoints included radiographic measures, operative time and complications.

Results: Mean pre-operative Cobb angle was 56.1°, 52.2° and 56.7° for the screw, hybrid and hook group respectively.

Structural curve correction was 63.6°, 60.2° and 58.5° for each group respectively. Compensatory curve correction favoured the hybrid and screw groups.

Thoracic kyphosis correction was 20.7° (most improved), 19.9°, and 15.5° for the screw, hook, and hybrid groups respectively.

Coronal alignment favoured the screw construct group.

Comparison of operative time revealed no significant difference, and complication rates were similar in nature and incidence for all three groups.

Conclusions: Results demonstrate improved correction of structural curve, kyphosis, and coronal alignment in the screw instrumentation group. No additional complications were observed with this method of AIS curve correction.

The abstracts were prepared by David AF Morgan. Correspondence should be addressed to him at davidafmorgan@aoa.org.au

Declaration of interest: a