Sultan Ahmed Maher, El Nawawy Walid, Dawood Mohammed Ahmad, Koptan Wael Tawfik, Elmiligui Yasser, Barakat Ahmed Samir, Fawaz Khaled Ahmed
Department of Orthopedic Surgery and Traumatolgy, Cairo University, Giza, Egypt.
Department of Orthopedic Surgery, Alexandria University Hospitals, Alexandria, Egypt.
J Craniovertebr Junction Spine. 2024 Jul-Sep;15(3):315-320. doi: 10.4103/jcvjs.jcvjs_52_24. Epub 2024 Sep 12.
Low-density screw constructs yield significant radiographic and clinical improvements with reduced risk of neurological complications. This study aimed to investigate the relationship between coronal Cobb angle and pelvic incidence (PI) in the correction of adolescent idiopathic scoliosis (AIS) using a low-density construct, as well as the association between PI and functional outcomes.
This prospective cohort study involved 60 posteriorly instrumented AIS patients, aged 10-16 years, with Cobb angles ranging from 45° to 90° of various Lenke types. Radiological assessments were conducted pre- and postsurgery at 1, 3, 6, 12, and 24 months. Functional evaluation utilized the Scoliosis Research Society score form (SRS-30).
A positive correlation was observed between screw density and operation time, blood loss, and degree of correction with SRS change (P = 0.004). No correlation was found between screw density and hospital stay, loss of correction, correction rate, SRS change, change in PI, or Cobb angle.
Correction of AIS through a posterior approach using a low-density construct can lead to satisfactory curve correction, impacting spinopelvic parameters. However, PI alone does not directly influence patient functional outcomes assessed by SRS-30. Low-density implant constructs reduce operative time, blood loss, costs, and complication risks.
低密度螺钉结构在改善影像学和临床效果方面效果显著，同时可降低神经并发症风险。本研究旨在探讨在采用低密度结构矫正青少年特发性脊柱侧凸（AIS）时，冠状面Cobb角与骨盆入射角（PI）之间的关系，以及PI与功能预后之间的关联。
这项前瞻性队列研究纳入了60例年龄在10至16岁之间、Lenke分型各异、Cobb角在45°至90°之间的接受后路器械固定的AIS患者。在术前以及术后1、3、6、12和24个月进行影像学评估。功能评估采用脊柱侧凸研究学会评分表（SRS-30）。
观察到螺钉密度与手术时间、失血量以及SRS变化的矫正程度呈正相关（P = 0.004）。未发现螺钉密度与住院时间、矫正丢失、矫正率、SRS变化、PI变化或Cobb角之间存在相关性。
采用低密度结构通过后路矫正AIS可实现令人满意的曲线矫正，影响脊柱骨盆参数。然而，单独的PI并不直接影响通过SRS-30评估的患者功能预后。低密度植入物结构可减少手术时间、失血量、成本和并发症风险。
