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Original Article, Deformities • Coluna/Columna 20 (1) • Jan-Mar 2021 • https://doi.org/10.1590/S1808-185120212001232530 copy

COMPARATIVE STUDY OF THE TYPES OF FIXATION IN ADOLESCENT IDIOPATHIC SCOLIOSIS

ESTUDO COMPARATIVO DOS TIPOS DE FIXAÇÃO NA ESCOLIOSE IDIOPÁTICA DO ADOLESCENTE

ESTUDIO COMPARATIVO DE LOS TIPOS DE FIJACIÓN EN LA ESCOLIOSIS IDIOPÁTICA DEL ADOLESCENTE

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To conduct a comparative study of the results obtained in the treatment of adolescent idiopathic scoliosis (AIS) with different types of fixations (traditional, selective and multiple), and to evaluate the correction of angular deformity in the frontal plane by the Cobb and sacral clavicular angle (SCA) methods.

Methods:

A study of a group of 278 patients with AIS who underwent selective, traditional, and multiple fixation surgeries.

Results:

Significant corrections of both the Cobb angle and the SCA were observed.

Conclusions:

In the multiple fixation surgeries there was a 100% correction between the preoperative and postoperative SCA values and a 50% correction in the traditional and selective fixations, a difference considered significant. Regarding the Cobb angle, the three fixations presented corrections between preop and postop with significant differences. Level of evidence III; Retrospective Study.

Keywords:
Spine Deformity; Scoliosis; Coronal Malalignment; Global Coronal; Deformity Angle

Variable	Method	Descriptive Measurements					P-value
Variable	Method	Operative	1Q	Median	3Q	%Variation	P-value
SCA	Multiple fixation	Pre	2.0	3.00°	6.00	-100%	p<0.001
SCA	Multiple fixation	Post	0.0	0.00°	2.00	-100%	p<0.001
SCA	Traditional fixation	Pre	0.0	2.00°	5.00	-50%	p<0.001
SCA	Traditional fixation	Post	0.0	1.00°	2.00	-50%	p<0.001
SCA	Selective fixation	Pre	0.0	2.00°	4.00	-50%	p<0.002
SCA	Selective fixation	Post	0.00	1.00°	3.75	-50%	p<0.002

Method	Descriptive Measurements								P-value
Method	N	Mean	S.D.	Minimum	Maximum	1Q	Median	3Q	P-value
Multiple fixation	93	2.27°	3.37	-7	15	0.00	2.00°	4.50	p<0.001
Traditional fixation	101	1.30°	3.78	-5	20	-1.00	0.00°	3.00
Selective fixation	84	0.30°	4.89	-10	32	-1.75	0.00°	2.00

Variable	Method	Descriptive Measurements					P-value
Variable	Method	Operative	1Q	Median	3Q	%Variation	P-value
Proximal thoracic curve	Traditional fixation	Pre	31.25	44.00°	67.75	-75%	p<0.001
Proximal thoracic curve	Traditional fixation	Post	8.00	11.00°	21.00	-75%	p<0.001
Proximal thoracic curve	Multiple fixation	Pre	30.00	33.00°	40.00	-78%	p<0.001
Proximal thoracic curve	Multiple fixation	Post	3.00	7.00°	10.00	-78%	p<0.001
Proximal thoracic curve	Selective fixation	Pre	28.00	35.00°	42.00	−60%	p<0.001
Proximal thoracic curve	Selective fixation	Post	9.00	14.00°	21.00	−60%	p<0.001

Method	Descriptive Measurements								P-value
Method	N	Mean	S.D.	Minimum	Maximum	1Q	Median	3Q	P-value
Multiple fixation	59	26.36°	7.72	8	44	21.00	27.00°	30.00	p<0.001
Traditional fixation	16	34.25°	16.72	12	78	21.50	33.00°	44.50	p<0.001
Selective fixation	31	18.45°	12.79	0	46	7.00	18.00°	26.00	p<0.001

Variable	Method	Descriptive Measurements					P-value
Variable	Method	Operative	1Q	Median	3Q	%Variation	P-value
Middle thoracic curve	Traditional fixation	Pre	45.00	55.00°	65.00	-87%	p<0.001
Middle thoracic curve	Traditional fixation	Post	3.00	7.00°	10.00	-87%	p<0.001
Middle thoracic curve	Multiple fixation	Pre	45.00	52.00°	62.00	-84.6%	p<0.001
Middle thoracic curve	Multiple fixation	Post	4.50	8.00°	12.00	-84.6%	p<0.001
Middle thoracic curve	Selective fixation	Pre	40.50	52.00°	61.00	-83.6%	p<0.001
Middle thoracic curve	Selective fixation	Post	4.00	8.50°	12.75	-83.6%	p<0.001

Method	Descriptive Measurements								P-value
Method	N	Mean	S.D.	Minimum	Maximum	1Q	Median	3Q	P-value
Multiple fixation	93	45.89°	15.0	13	98	36.00	45.00°	52.50	p=0.032
Traditional fixation	95	48.23°	14.09	10	100	40.00	47.00°	56.00	p=0.032
Selective fixation	84	42.00°	17.26	8	82	30.00	45.00°	53.00	p=0.032

Variable	Method	Descriptive Measurements					P-value
Variable	Method	Operative	1Q	Median	3Q	%Variation	P-value
Lumbosacral curve	Traditional fixation	Pre	42.25	53.00°	70.25	-85%	p<0.001
	Traditional fixation	Post	4.25	8.00°	13.75
Lumbosacral curve	Multiple fixation	Pre	38.00	45.00°	54.00	-84.4%	p<0.001
	Multiple fixation	Post	4.00	7.00°	10.00
Lumbosacral curve	Selective fixation	Pre	40.00	46.00°	52.50	-76%	p<0.001
	Selective fixation	Post	6.00	11.00°	18.00

Method	Descriptive Measurements								P-value
Method	N	Mean	S.D.	Minimum	Maximum	1Q	Median	3Q	P-value
Multiple fixation	79	38.44°	12.12	6	62	30.00	39.00°	47.00	p=0.001
Traditional fixation	36	46.64°	15.89	2	75	38.00	45.00°	58.00	p=0.001
Selective fixation	72	37.06°	15.96	12	102	28.25	36.00°	43.00	p=0.001

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E-mail: coluna.columna@uol.com.br

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