Comparative Analysis of Monoaxial and Polyaxial Pedicle Screws in the Surgical Correction of Adolescent Idiopathic Scoliosis

Jae Hyuk Yang; Hong Jin Kim; Tae Yeong Chang; Seung Woo Suh; Dong-Gune Chang

doi:10.3390/jcm13092689

Comparative Analysis of Monoaxial and Polyaxial Pedicle Screws in the Surgical Correction of Adolescent Idiopathic Scoliosis

J Clin Med. 2024 May 3;13(9):2689. doi: 10.3390/jcm13092689.

Authors

Jae Hyuk Yang¹, Hong Jin Kim², Tae Yeong Chang¹, Seung Woo Suh³, Dong-Gune Chang²

Affiliations

¹ Department of Orthopaedic Surgery, Korea University Anam Hospital, College of Medicine, Korea University, Seoul 02841, Republic of Korea.
² Department of Orthopaedic Surgery, Inje University Sanggye Paik Hospital, College of Medicine, Inje University, Seoul 01757, Republic of Korea.
³ Department of Orthopedic Surgery, Korea University Guro Hospital, College of Medicine, Korea University, Seoul 08308, Republic of Korea.

Abstract

Background: Although several biomechanical studies have been reported, few clinical studies have compared the efficacy of monoaxial and polyaxial pedicle screws in the surgical treatment of adolescent idiopathic scoliosis (AIS). This study aims to compare the radiological and clinical outcomes of mono- and polyaxial pedicle screws in the surgical treatment of AIS. Methods: A total of 46 AIS patients who underwent surgery to treat scoliosis using pedicle screw instrumentation (PSI) and rod derotation (RD) were divided into two groups according to the use of pedicle screws: the monoaxial group (n = 23) and polyaxial group (n = 23). Results: The correction rate of the main Cobb's angle was higher in the monoaxial group (70.2%) than in the polyaxial group (65.3%) (p = 0.040). No differences in the rotational correction of the apical vertebra were evident between the two groups. SRS-22 scores showed no significant differences according to the type of pedicle screws used. Conclusions: The use of polyaxial pedicle screws resulted in coronal, sagittal, and rotational correction outcomes comparable to those associated with the use of monoaxial pedicle screws for surgical treatment using PSI and RD to treat moderate cases of AIS.

Keywords: adolescent idiopathic scoliosis; correction; monoaxial pedicle screws; polyaxial pedicle screws; rod derotation.

Grants and funding

This study was conducted with the support of research funding from Korea University and was authored with the assistance of the Scoliosis Research Institute affiliated with Korea University.