The Influence of Segmental Pedicle Screw Fixation on Distal Fusion Level in KingType I Adolescent Idiopathic Scoliosis(AIS).
- Author:
Se Il SUK
;
Jin Hyok KIM
;
Won Joong KIM
;
Dong Soo KIM
;
Sang Min LEE
;
Jin Hae KIM
- Publication Type:Original Article
- MeSH:
Adolescent*;
Congenital Abnormalities;
Follow-Up Studies;
Humans;
Spine
- From:Journal of Korean Society of Spine Surgery
1997;4(2):273-280
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
STUDY DESIGN: This study analyzes the influence of segmental pedicle screw fixation on distal fusion extent of King type I adolescent Idiopathic scoliosis(AIS). OBJECTIVES: To verify the efficacy of segmental pedicle screw fixation in preservation of distal lumbar motion segments. SUMMARY OF BACKGROUND DATA: King type I AIS has usually been treated by fusion to L4. However, segmental pedicle screw fixation may shorten the distal fusion extent by reducing the hopi-Bontal tiIt of the lower end vertebra. MATERIALS AND METHODS: Eighteen King type I AIS subjected to segmental pedicle screw fixation of both curves were analyzed after a minimum follow-up of 2 years. Fourteen were fused to L3(short fusion group, SF) and 4 were fused to L4(long fusion group, LF). They were compared for correction of deformity, spinal balance and L4 tiIt. RESULTS: In SF group, the thoracic currie showed 71.6% correction. Lumbar curve and L4 tiIt corrections were 76.8% and 75.2% respectiveIY. In LF group, the thoracic currie showed 65.2% correction. Lumbar currie and L4 tilt corrections were 76.8% and 78.4% respectively. There was no significant difference between two groups. Spinal balance was maintained in all patients(SF 14/14; LF 4/4). CONCLUSIONS: Segmental pedicle screw fixation may shorten the distal fusion extent of King type IAIS to L3, preserving a distal motion segment with a correction of deformity and spinal balance comparable to fusion down to L4. It is attributed to enhanced segmental control of the system enabling horizontalization of L4.
