115
views
0
recommends
+1 Recommend
0 collections
    3
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Adolescent idiopathic scoliosis (AIS) treated with arthrodesis and posterior titanium instrumentation: 8 to 12 years follow up without late infection

      research-article

      , 1 , 1

      Scoliosis

      BioMed Central

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          There are no data in the peer-reviewed literature regarding long term results in patients treated for AIS with a posterior titanium instrumentation. Therefore we assessed the outcome in 50 patients treated by titanium implant.

          Methods

          A total of 50 patients with a mean age of 16.6 years were treated. In all patients, titanium hooks and pedicle screws were used in combination. The demographic data and the pre- and post-operative radiographs of all 50 patients were re-examined, and 49 of the 50 patients (98%) attended a radiological and clinical follow up-examination on average 10.1 years post-operatively. The clinical results were recorded by means of the SRS 24 questionnaire.

          Results

          In the frontal plane, the mean pre-operative thoracic and lumbar curve had been 62.4° and 43.5° respectively, post-operatively the curves were reduced to 26.9° and 16.3°, resulting in a correction rate of 56.9% for thoracic and 62.5% for lumbar curve. At the follow up-evaluation, the Cobb angle of the thoracic and lumbar curve was 31.0° and 21.3° respectively, giving a final correction rate of 50.3% for thoracic, and 51.0% for lumbar curve. 7 of the 50 patients (14.3%) had undergo revision surgery for complications, but complete implant removal was necessary in only one case. Analysis of the SRS 24 questionnaire showed an average score of 95.8 points.

          Conclusion

          Posterior titanium instrumentation is a safe and effective procedure in the surgical correction of AIS. In this retrospective study with small patient number, it shows favourable long-term results; in particular, the loss of correction is low, no late infection occurred and there was a very high survival rate of the implant itself.

          Related collections

          Most cited references 25

          • Record: found
          • Abstract: not found
          • Article: not found

          Outlines for the study of scoliosis

           J Cobb,  JL Cobb,  JR Cobb (1948)
            Bookmark
            • Record: found
            • Abstract: not found
            • Article: not found

            Treatment of scoliosis. Correction and internal fixation by spine instrumentation.

              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Delayed infections following posterior spinal instrumentation for the treatment of idiopathic scoliosis.

              Ten patients who had been managed with posterior spinal arthrodesis and Texas Scottish Rite Hospital instrumentation because of idiopathic scoliosis had a delayed deep wound infection at an average of twenty-five months after the operation. The signs of infection included spontaneous drainage in eight patients and fluctuance in two patients. In addition, six patients--including five of the eight who had drainage--had mild pain in the back. The average erythrocyte sedimentation rate was thirty-nine millimeters per hour (range, nineteen to eighty-one millimeters per hour). The instrumentation was removed from all of the patients. In two patients, a pseudarthrosis that had not been noted on preoperative radiographs was noted intraoperatively; in both patients, the pseudarthrosis occurred at a level at which two hooks had been placed in one intervertebral space. Primary closure was performed in seven patients, and delayed primary closure was performed on the third postoperative day in three patients. All wounds healed uneventfully. Cultures of specimens taken from deep within the wound were positive for Propionibacterium acnes (five patients), Staphylococcus epidermidis (two patients), a rare coagulase-negative Staphylococcus species (one patient), or Micrococcus varians (one patient). No organisms grew on culture of the specimen obtained from the remaining patient. Propionibacterium acnes required an extended period of incubation before identification. Antibiotics were administered parenterally to all of the patients after the removal of the hardware, and this treatment was followed by oral administration of antibiotics for nine of the patients. We suspect--but can not prove--that several of the delayed infections resulted from intraoperative seeding and remained subclinical for an extended period of time.
                Bookmark

                Author and article information

                Journal
                Scoliosis
                Scoliosis
                BioMed Central
                1748-7161
                2009
                12 August 2009
                : 4
                : 16
                Affiliations
                [1 ]Department of Spinal Surgery and Scoliosis Center, Behandlungszentrum Vogtareuth, Germany
                Article
                1748-7161-4-16
                10.1186/1748-7161-4-16
                2734567
                19674461
                ce267e4c-ee70-47ef-ba6c-fd64a9794c2f
                Copyright © 2009 Mueller and Gluch; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Categories
                Research

                Orthopedics

                Comments

                Comment on this article