Comparative Analysis Of Segmental Pedicle Screw Versus Pedicle Screw Combined Hook In Correction Of Lenke1Adolescent Idiopathic Scolioticrib Hump Deformity

ObjectiveTo compare the results in the treatment of Lenke1adolescent idiopathic scoliosis(AIS) patients of rid hump by means of segmental pedicle screws and pedicle screws combined with hooks.MethodsFrom May2004to October2010,sixty-two patients with Lenke1AIS of rid hump were randomly divided into two groups, placement. Au patients had preoperative coronal Cobb ansle of main thoracic curve less than60°.and the flexibility greater than50%.In group1. posterior fusion was performed using segmental screw placement, and in group2, with pedicle screws(20%) combined hooks(80%). The following variables including radiographic study, pulmonary function tests, operative time, intraoperative blood loss. and SRS-22scores were carried in both groups.Results After surgery, The average operation time was303±27.1mi307±17.9min, and the average blood loss was803±76.6ml824±56.2ml. No neurovascular injury was noted. In the A group, the thoracic curve was corrected from51.2±4.6°to9.4±1.0(82±10%correction) and in the B group from52.7±5.3°o14.67±0.52°(72±12%). There was difference in postoperative spinal the thoracic curve among the2groups(P<0.05). the correction rate of derotation degree was much higher in group A(50%) than that in group B(30%)(P<0.05) The correction rates of hump height and angle were66.3%and71.4%in the B group, respectively,67.1%and72.1%. The A group showed significantly better correction of rib hump and self-image score in the SRS-22questionnaire than the B group. At the3th month follow-up, The A group,the absolute values of FVC and FEV1increased espectively, while the percent predicted values of FVC and FEV1increased. In the B group, the absolute values of FVC and FEV1decreased, while the percent predicted values of FVC and FEV1decreased.At the final investigation, All the parameters of the pulmonary function demonstrated a slight increase.with no statistical significance (P>0.05). All patients without neurological spinal cord injury, infection and other complications. Group A patients due to the poor effect of surgey. and did thoracoplasty. Group B two cases without doing thoracoplasty. Group B rib resection for4to6, with an average of4.1. one case due to the convex side rib resection excessive chestwall depression caused by difficulty in breathing,. One cases of postoperative pneumothorax, puncture exhaust after bandaged improved after treatment. One cases of local skin complaint postoperative numbness or hypoesthesia, feel diminished the symptoms were relieved when the last follow-up. ConlusionsSegmental pedicle screws instrumentation offer a better three dimensional correction after posterior surgery than pedicle screws combined hooks in Lenke1AIS patients. Segmental pedicle screws instrumentation offer good rib hump correction,satisfactory clinical outcomes without pulmonary function compromise.The patients need not to undergo thoracoplasty.