Surgeons should consider low implant density constructs for posterior spinal fusion
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Low implant density constructs for posterior spinal fusion of pediatric patients with Lenke 1A curves between 45° and 65° showed equivalent percent coronal Cobb angle correction to high density implants, according to published results.
A. Noelle Larson, MD, presented findings of her study for treatment of adolescent idiopathic scoliosis at the Pediatric Orthopaedic Society of North America Annual Meeting, which was held as a virtual meeting.
“This was a prospective, randomized clinical trial, and we randomized patients to a high implant density (HD), or 1.8 screws per level fused, vs. low implant density (LD), 1.4 or fewer screws per level fused,” Larson said in her presentation. “Our primary outcome measure – again – was percent correction of major Cobb [angle] at 3 months, 1-year and 2-year follow-up.”
The final analysis included 206 patients, with 189 patients making the 3-month follow-up, 156 for the 1-year follow-up and 124 for the 2-year follow-up.
Mean percent Cobb correction was 74% in HD and was 70% in LD at 3 months, was 69% in HD and was 66% in LD at 1 year, and was 67% in HD and was 64% in LD at 2 years, according to the abstract.
“We had no differences as far as gender, age, race, height, weight or trunk rotation preoperatively,” Larson said. “We had thought there would be a difference in blood loss and surgical time [postoperatively], but there was not.”
“I think, based on our results, surgeons could consider a low implant density construct for Lenke 1A curve patterns for routine surgery,” Larson said. – by Max R. Wursta
Larson AN, et al. Paper 64. Presented at: Pediatric Orthopaedic Society of North America Annual Meeting; May 13, 2020 (virtual meeting).
Disclosure: Larson reports she is an unpaid consultant for Globus Medical, provides research support for Medtronic and Zimmer Biomet, and is a board or committee member on the Scoliosis Pediatric Orthopaedic Society of North America and the Scoliosis Research Society.
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