Internal Fixation With Posterior Pedicle Screw-Rod System For Adolescent Idiopathic Scoliosis

Objective:To explore the surgical method and clinical effect for the treatment of adolescent idiopathic scoliosis with posterior pedicle screw-rod system.Materials and methods:From July 2007 to July 2013,34 cases of children with AIS were instrumented with posterior pedicle screw-rod system under general anesthesia and intraoperative neurophysiological monitoring.15 cases were male,19 cases were female.Aged from 10 to 17.5 yrs,average 14.6 yrs. Course was 1-10 yrs, average 3.4 yrs. Cobb’s angle was 42～76 degrees,average 54 degrees. Preoperatively,34 cases whose shoulders were not even,22 cases with razor back deformity, 17 cases with compensatory pelvic tilt,12 cases with pain in back.Height ranged from 128 to 162cm,average 147cm.Results:All the cases had the operation done, there was no neurological complication, important vascular and pleural cavity injury.Surgical time ranged 3～5.5 h, average 4h.Mean blood loss was 650ml(450-1150ml).Cobb’s angle was 5-29 degrees,average 15 degrees,and the correction rate was 72.2%.Height increased 3-7cm.The duration of follow-up ranged 19-60 months,average 36 months.No death, paraplegia and screw loosening or fragmentation occurred. In the postoperative 6th-12th X-ray image showed that all the patients had good bone graft fusion and no loss of spinal corrective angle after operations. Clinical manifestations and appearance had improved significantly,3 cases had mild low back pain, without affecting the daily life. Incision infection in 2 cases and healed after conservative treatment.The evaluation of curative effect:22 cases of excellent,9 cases of good,3cases of middle, none of poor. The rate of excellent and good reached 91.2%.Conclusion:Internal fixation with posterior pedicle screw-rod system for AIS can get satisfactory corrective effect, solid and stable fixation.The technique can correct spine and thoracic appearance, improve cardiopulmonary function, reduce or eliminate the psychological stress, improve their quality of life. It is one of the effective methods for treatment of children with AIS.