EP210
E-Poster
Radiographic and Surgical Outcomes of Hybrid Versus All–Transpedicle Screw Constructs in Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis with a Minimum Two-year Follow-up
Yun-Shiuan Wang, MD, Yu-Cheg Yao, MD, Shih-Tien Wang, MD, MHA
Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
Hypothesis: This study aimed to compare surgical outcomes between all–pedicle screw (all-TPS) and hybrid constructs in adolescent idiopathic scoliosis.
Study Design: A retrospective comparative cohort study.
Introduction All-TPS constructs has been reported with superior radiographic correction without increasing surgical morbidity remains controversial. This study aimed to compare demographic characteristics, radiographic outcomes, and surgical parameters between hybrid and all-TPS instrumentation.
Methods: From January 2010 through December 2023, 138 patients undergoing surgical treatment were included; 83 patients were assigned to the hybrid group and 55 to the all-TPS group. Demographic data, curve types, and preoperative radiographic parameters were comparable between groups. Radiographic outcomes—including major curve Cobb angle, correction rate, sagittal alignment, coronal balance, apical vertebral rotation, and the Cincinnati Correction Index (CCI)—were evaluated at 1 month postoperatively and at final follow-up. Surgical parameters, including implant density, number of fused segments, estimated blood loss (EBL), and operative time, were also analyzed.
Results: Preoperatively, the all-TPS group demonstrated a larger major curve (57.8° vs. 50.1°, p < 0.001). At 1 month postoperatively, the all-TPS group achieved a significantly lower residual Cobb angle (18.1° vs. 23.9°, p = 0.002) and a higher correction rate (70% vs. 53%, p < 0.001). At final follow-up, a superior correction rate was maintained in the all-TPS group (66% vs. 47%, p < 0.001). Sagittal alignment, coronal balance, apical vertebral rotation, and CCI were comparable between groups at all time points. Implant density was significantly higher in the all-TPS group (1.8 vs. 0.8, p < 0.001), whereas the number of fused segments, EBL, and operative time showed no significant differences.
Conclusions: All-TPS constructs provide significantly greater coronal plane correction compared with hybrid constructs, both early postoperatively and at final follow-up, without adversely affecting sagittal alignment, balance, or perioperative surgical outcomes. Although higher risks have been reported with all-TPS constructs, these findings support the use of all-TPS instrumentation as an effective strategy for scoliosis correction.