The Incidence of Screw Failure in Fenestrated Polyaxial Pedicle Screws vs. Conventional Pedicle Screws in the Treatment of Adolescent Idiopathic Scoliosis (AIS)

: Adolescent idiopathic scoliosis (AIS) is a spinal pathology affecting 0.47-5.2% of the population, often requiring surgical intervention to control deformity progression. Posterior spinal instrumentation and fusion with pedicle screw fixation are standard procedures for AIS curve correction; howev...

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Published inJournal of clinical medicine Vol. 13; no. 6; p. 1760
Main Authors Velluto, Calogero, Inverso, Michele, Borruto, Maria Ilaria, Perna, Andrea, Bocchino, Guido, Messina, Davide, Proietti, Luca
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 01.03.2024
MDPI
Subjects
adolescent idiopathic scoliosis
Back surgery
Care and treatment
Clinical outcomes
Complications and side effects
Failure
Females
hardware failure
Methods
pedicle screw
posterior fusion
Scoliosis
Spinal fusion
Surgeons
Surgical techniques
Vertebrae
Work stations
Italy
United States > US
pedicle screw
hardware failure
posterior fusion
adolescent idiopathic scoliosis
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Summary:: Adolescent idiopathic scoliosis (AIS) is a spinal pathology affecting 0.47-5.2% of the population, often requiring surgical intervention to control deformity progression. Posterior spinal instrumentation and fusion with pedicle screw fixation are standard procedures for AIS curve correction; however, implant failure remains a significant complication, especially in multi-level fusions. This retrospective cohort study aims to compare the failure rates between conventional pedicle screws (CPSs) and fenestrated pedicle screws (FPSs) in AIS treatment, with a focus on investigating potential causes of these failures. : This study, conducted from January 2016 to December 2020, involves a two-center retrospective analysis of AIS patients undergoing posterior instrumented fusion. : Data from a total of 162 patients (122 females and 40 males) revealed a mean age of 14.95 years (range: 11-18). The CPS group consisted of 80 patients (56 females and 24 males), whereas the FPS group consisted of 82 patients (66 females and 16 males) stratified by Risser grade and Lenke Classification. Radiological assessments, clinical outcomes, and SRS-22 scores were evaluated pre-operatively, at 6 months, and post-operatively (minimum follow-up of 2 years). : Fenestrated pedicle screws (FPSs) pose concerns due to their lower mechanical strength compared to solid screws. Understanding their limitations and optimizing their application in AIS treatment is essential.
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ISSN:2077-0383
2077-0383
DOI:10.3390/jcm13061760