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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2016

Open Access 01-12-2016 | Research article

Comparison between harvesting and preserving the spinous process for adolescent idiopathic scoliosis

Authors: Yu-Cheng Yeh, Chi-Chien Niu, Lih-Huei Chen, Wen-Jer Chen, Po-Liang Lai

Published in: BMC Musculoskeletal Disorders | Issue 1/2016

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Abstract

Background

Spinous process has been routinely resected during posterior fusion of adolescent idiopathic scoliosis for fusion bed preparation and local autologous bone graft supplement. However, spinous process serves as an important structure in posterior ligament complex and was the anchorage of paraspinal muscle groups. With the development of pedicle screws instrumentation and the potential fusion ability in children, the need for resecting spinous process in this procedure could be further investigated. The purpose of this study was to compare the fusion rates, surgical outcomes and complications between harvesting and preserving the spinous process in posterior fusion of adolescent idiopathic scoliosis.

Methods

From January 2003 to December 2008, 104 consecutive adolescent idiopathic scoliosis patients underwent primary posterior fusion with local autologous bone grafts and following for a minimum of 24 months were reviewed. The patients were divided into a harvesting group (n = 61) with the spinous process harvested, and a preserving group (n = 43) with the spinous process preserved. Blood loss, radiographic assessments, and clinical outcomes were compared between the two groups.

Results

There were no significant differences in duration of surgery and peri-operative blood transfusion between the two groups. However, blood loss was statistically greater (983 ± 446 ml vs. 824 ± 361 ml; p = 0.048) and duration of hospitalization was statistically longer (7.4 ± 1.0 days vs. 6.8 ± 0.8 days; p = 0.003) in the harvesting group. The pre- and post-operative structural curves, correction rates, sagittal profile and loss of corrections were similar in both groups. Based on radiographic evaluation, the incidences of pseudoarthrosis were similar in both groups (3/61 vs. 2/43; p = 0.95). The incidence of prescribing pain medication for back discomfort during follow-up was statistically higher in the harvesting group (16/61 vs. 4/43; p = 0.03).

Conclusions

The surgical outcomes and fusion rates between harvesting and preserving the spinous process were comparable. Resecting the spinous process as local autologous bone graft may not be necessary in posterior fusion for adolescent idiopathic scoliosis patients.
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Metadata
Title
Comparison between harvesting and preserving the spinous process for adolescent idiopathic scoliosis
Authors
Yu-Cheng Yeh
Chi-Chien Niu
Lih-Huei Chen
Wen-Jer Chen
Po-Liang Lai
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2016
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-016-1222-5

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