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Single- versus dual-rod anterior instrumentation of thoracolumbar curves in adolescent idiopathic scoliosis

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Abstract

Purpose

Single or dual-rod instrumentation can be used for the anterior fixation of the spine in adolescent idiopathic scoliosis (AIS). We aim to compare the complications, radiographic and functional outcomes of patients with AIS who have undergone single and dual-rod instrumentation.

Methods

This is a multi-centre study involving the Royal Children’s, Royal Melbourne and Epworth hospitals. Three primary surgeons were involved to ensure homogeneity of surgical technique and implants. Patients with AIS and thoracolumbar curves (Lenke 5 and 6) undergoing anterior instrumentation from 1st January 2000 to 30th June 2013 were included. Radiographic data were collected from X-rays. The functional outcome was measured through the Scoliosis Research Society questionnaire (SRS-30).

Results

The study included 58 patients (38 single-rod and 20 dual-rod patients). Thirty-nine patients were classified with Lenke 5 curves, while 19 patients had Lenke 6 curves. Structural interbody supports were used in 95 % of cases. In the preoperative to postoperative period, patients with single rods had an improvement of 75 and 51 % for primary and secondary curves, respectively, while patients with dual rods had an improvement of 70 and 38 % for primary and secondary curves, respectively. There were no cases of pseudoarthrosis or metalware failure in either group. Two patients (one single-rod and one dual-rod patient) required further unplanned posterior fusion. 91 % of patients were satisfied with the results of their back management.

Conclusion

Pseudoarthrosis and metalware failure are rare complications of anterior instrumentation. Our study found no significant difference in functional or radiographic outcome between single and dual-rod instrumentation.

Level of evidence

Level III

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Authors and Affiliations

  1. Department of Orthopaedics, The Royal Melbourne Hospital, Parkville, VIC, 3050, Australia

    Mithun Nambiar & Peter L. Turner

  2. Department of Orthopaedics, The Royal Children’s Hospital, Parkville, VIC, 3052, Australia

    Yi Yang, Susan Liew & Ian P. Torode

  3. Epworth Hospital, Richmond, VIC, 3121, Australia

    Peter L. Turner & Ian P. Torode

Authors
  1. Mithun Nambiar
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  2. Yi Yang
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  3. Susan Liew
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  4. Peter L. Turner
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  5. Ian P. Torode
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Correspondence to Mithun Nambiar.

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Additional information

For Ian: a brilliant mind, a wonderful surgeon and a big kid. Our colleague, our mentor and our friend. We will miss you.

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Nambiar, M., Yang, Y., Liew, S. et al. Single- versus dual-rod anterior instrumentation of thoracolumbar curves in adolescent idiopathic scoliosis. Eur Spine J 25, 3249–3255 (2016). https://doi.org/10.1007/s00586-015-4360-9

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  • DOI: https://doi.org/10.1007/s00586-015-4360-9

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