Effect of higher implant density on curve correction in dystrophic thoracic scoliosis secondary to neurofibromatosis Type 1.
OBJECTIVE The aim of this study was to investigate how implant density affects radiographic results and clinical outcomes in patients with dystrophic scoliosis secondary to neurofibromatosis Type 1 (NF1). METHODS A total of 41 patients with dystrophic scoliosis secondary to NF1 who underwent 1-stage posterior correction between June 2011 and December 2013 were included. General information about patients was recorded, as were preoperative and postoperative scores from Scoliosis Research Society (SRS)-22 questionnaires. Pearson correlation analysis was used to analyze the associations among implant density, coronal Cobb angle correction rate and correction loss at last follow-up, change of sagittal curve, and apical vertebral translation. Patients were then divided into 2 groups: those with low-density and those with high-density implants. Independent-sample t-tests were used to compare demographic data, radiographic findings, and clinical outcomes before surgery and at last follow-up between the groups. RESULTS Significant correlations were found between the implant density and the coronal correction rate of the main curve (r = 0.505, p < 0.01) and the coronal correction loss at final follow-up (r = -0.379, p = 0.015). There was no significant correlation between implant density and change of sagittal profile (p = 0.662) or apical vertebral translation (p = 0.062). The SRS-22 scores improved in the appearance, activity, and mental health domains within both groups, but there was no difference between the groups in any of the SRS-22 domains at final follow-up (p > 0.05 for all). CONCLUSIONS Although no significant differences between the high- and low-density groups were found in any of the SRS-22 domains at final follow-up, higher implant density was correlated with superior coronal correction and less postoperative correction loss in patients with dystrophic NF1-associated scoliosis.
['Li|Yang|Y|', 'Yuan|Xinxin|X|', 'Sha|Shifu|S|', 'Liu|Zhen|Z|', 'Zhu|Weiguo|W|', 'Qiu|Yong|Y|', 'Wang|Bin|B|', 'Yu|Yang|Y|', 'Zhu|Zezhang|Z|']
D000293:Adolescent D001863:Bone Screws D002648:Child D005260:Female D005500:Follow-Up Studies D006801:Humans D008279:Magnetic Resonance Imaging D008297:Male D009456:Neurofibromatosis 1 D012189:Retrospective Studies D012600:Scoliosis D013123:Spinal Fusion D011795:Surveys and Questionnaires D013904:Thoracic Vertebrae D014057:Tomography, X-Ray Computed D016896:Treatment Outcome
implant density neurofibromatosis Type 1 radiographic results clinical outcomes correction rate correction loss AVT = apical vertebral translation HD = high density LD = low density MCID = minimal clinically important difference NF1 = neurofibromatosis Type 1 SRS = Scoliosis Research Society spine