Posterior only pedicle screw construct for the treatment of scoliotic curves greater than 90 degrees
Kola Jegede
Yongjung J Kim
Zaomin Zheng
Gene Cheh
Samuel Cho
Sally Pak
Abstract：Study design A retrospective comparative study. Objective To assess the efifcacy and safety of posterior only pedicle screw construct ( POPS ) for the treatment of scoliotic curves>90 degrees using radiographic outcomes and various clinical outcomes. Summary of Background Data A paucity of data exists regarding standardized surgical options for severe scoliotic curvatures > 90°. Perioperative traction or staged anterior and posterior operations were the traditional surgical options. Methods A total of 40 consecutive scoliosis patients with curves>90° ( average 111.4°;range 91°-175° ) with an ( average follow-up of 31 months;range 6-60 months ) who underwent spinal instrumented fusion with posterior only pedicle screw constructs performed by a single surgeon were analyzed. Diagnoses included idiopathic scoliosis ( n=27 ), congenital ( n=9 ), neuromuscular ( n=3 ), and syndromic ( n=1 ). In total, 25 patients were treated with posterior only pedicle screw constructs with multiple Ponte ostotomies while the other 15 patients with posterior vertebral column resection. Radiographic examinations and complications were analyzed. Results Radiographic outcomes demonstrated an average major curve correction of 49%and 47%at eight weeks post operation and final follow-up respectively ( P<0.001 ). Total deformity angle, major Cobb’s angle+maximal kyphosis with an average of 160 degrees preoperatively, showed an average correction of 50%and 48%at eight weeks post operation and ifnal follow-up respectively ( P<0.001 ). There were seven cases ( 18%) of intraoperative MEP ( motor evoked potential ) loss and four patients ( 10%) with transient spinal cord deifcit. One patient developed postoperative infection. Another patient had a unilateral broken rod in two years follow-up which was treated with observation. Conclusions Scoliosis patients with curve>90 degree can be managed successfully by posterior only pedicle screw construct ( POPS ). POPS avoids the need for anterior surgical procedures or perioperative traction while achieving acceptable correction safely without signiifcant complication.
Keywords：Spinal curvaturesScoliosisPostoperative complicationsOrthopedic procedures
Publication Date：2014-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 890-895 )