Comparing Uniplanar and Multiaxial Pedicle Screws in the Derotation of Apical Vertebrae for Lenke V Adolescent Idiopathic Scoliosis: A Case-Controlled Study

摘要

ObjectiveTo compare effects of uniplanar and multiaxial pedicle screws on apical vertebral derotation efficiency in patients with Lenke V adolescent idiopathic scoliosis. MethodsFor this retrospective study, patients with Lenke V adolescent idiopathic scoliosis with uniplanar pedicle screws (group I) and multiaxial pedicle screws (group II) were collected from January 2013 to December 2015. Grade of apical vertebral rotation was evaluated before and after surgery using the Nash-Moe and Upasani methods, respectively. The Scoliosis Research Society-22 scale was also used to evaluate patient satisfaction. ResultsThere were no significant differences in terms of age, duration of follow-up, correction ratio, and preoperative level of apical rotation between groups (P< 0.05). Group I showed better apical vertebral derotation than group II (level 0, 10.5% vs. 2.3%; level I, 71.1% vs. 38.6%; level II, 18.4% vs. 59.1%;P?= 0.001). The progression group showed lower bone maturity (odds ratio 52.0; 95% confidence interval, 6.3–430.7;P< 0.0001) in group I, and similar results were observed in group II (OR 12.3; 95% confidence interval, 1.3–121.3;P?= 0.057). Patients in group I showed better satisfaction than patients in group II based on Scoliosis Research Society-22 scores (P< 0.05). ConclusionsBoth types of pedicle screws could provide effective correction, but the uniplanar pedicle screw was better for derotation of vertebrae and provided patients with better satisfaction. Skeleton immaturity was positively correlated with progression of vertebral rotation after surgery.