Comparative Analysis of Pedicle Screw Versus Hook Instrumentation in Posterior Spinal Fusion of Adolescent Idiopathic Scoliosis

To comprehensively compare the 2-year postoperative results of posterior correction and fusion with segmental pedicle screw instrumentation versus those with hook constructs in adolescent idiopathic scoliosis (AIS) treated at a single institution. SUMMARY OF BACKGROUND DATA: Despite the reports of satisfactory correction and maintenance of scoliotic curves by pedicle screw instrumentation compared to hook constructs, few reports on the comprehensive comparison of segmental pedicle screw instrumentation versus hook instrumentation exist.

A total of 52 patients with AIS at a single institution who underwent a posterior spinal fusion with segmental pedicle screw (26) or hook (26) instrumentation were sorted and matched according to four criteria: similar age at surgery (14.8 years in pedicle screw group and 14.2 years in hook group), identical Lenke curve types, same number of fused vertebrae (11.7 in each group), and identical operative methods (18 posterior spinal fusions with thoracoplasty, 4 posterior spinal fusions with iliac crest bone graft, and 4 anterior and posterior spinal fusions in each group). Patients were evaluated before surgery, immediate after surgery, and at the 2-year follow-up according to radiographic changes in curve correction, pulmonary function tests, operative time, intraoperative blood loss, implant costs, and SRS-24 scores.