Despite the myriad new spinal instrumentation systems, scoliosis can rarely be fully corrected, especially when the curves are stiff. A novel superelastic nickel-titanium (nitinol) rod that maximises the ability to slowly correct spinal deformities by utilising the viscoelastic properties of the spine has been developed. This parallel, double-blinded, randomised controlled trial compared the safety and efficacy of these new rods to conventional titanium rods in 23 patients with adolescent idiopathic scoliosis. The superelastic nitinol rods were found to be safe, could gradually correct scoliosis curves, and ultimately resulted in better coronal and sagittal alignments compared to traditional rods. Despite the myriad new spinal instrumentation systems, scoliosis can rarely be fully corrected, especially when the curves are stiff. A novel superelastic nickel-titanium (nitinol) rod that maximises the ability to slowly correct spinal deformities by utilising the viscoelastic properties of the spine has been developed. This parallel, double-blinded, randomised controlled trial compared the safety and efficacy of these new rods to conventional titanium rods in 23 patients with adolescent idiopathic scoliosis. The superelastic nitinol rods were found to be safe, could gradually correct scoliosis curves, and ultimately resulted in better coronal and sagittal alignments compared to traditional rods.
With the use of each pedicle screw for surgical correction of adolescent idiopathic scoliosis (AIS), there is an increase in instrumentation-related costs, operative time, risk of neural injury, and overall health-care expenses. As such, alternate level screw strategy (ALSS) has been reported as a potential alternative to contiguous multilevel screw strategy (CMSS). Moreover, studies have shown the importance in accounting for the flexibility of the curve based on the fulcrum bending radiograph when assessing postoperative curve correction. Therefore, this study addressed a radiographic and cost analysis comparing CMSS with ALSS for the treatment of thoracic AIS with titanium screws and rod application. 77 patients with AIS underwent surgery (range 6–15 levels). 35 patients received CMSS, which was characterised as bilateral screw fixation at every level. 42 patients underwent ALSS, which entailed bilateral screw fixation at alternate levels. Titanium rods were used in all cases. Preoperative and postoperative posteroanterior and fulcrum bending radiographic Cobb angles were obtained for all patients. The fulcrum flexibility and the fulcrum bending correction index (FBCI) were assessed. Cost analysis was also done.Introduction
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