Skip to main content
Top
Published in: European Spine Journal 6/2014

01-06-2014 | Original Article

CoCr rods provide better frontal correction of adolescent idiopathic scoliosis treated by all-pedicle screw fixation

Authors: Mayalen Lamerain, Manon Bachy, Marion Delpont, Reda Kabbaj, Pierre Mary, Raphaël Vialle

Published in: European Spine Journal | Issue 6/2014

Login to get access

Abstract

Purpose

Pedicle screw fixation is considered biomechanically advantageous in adolescent idiopathic scoliosis (AIS) correction, because it uses as an anchor the pedicle, which is the hardest part of the vertebral body. The ability of the rod to correct and hold the correction is a key factor in the selection of rod material. The goal of this study was to compare the results obtained by stainless steel (SS) and cobalt–chromium (CoCr) rods materials for the treatment of AIS curves.

Methods

Ninety patients were retrospectively included. Sixty-four patients (group 1) were operated on using CoCr rods. Twenty-six patients (group 2) were operated on using SS rods. All the patients were treated by the same surgeon using all-pedicle screw constructs.

Results

In group 1, the correction was respectively 41.03° and 35.78° for main and secondary curves. In group 2, the correction was respectively 30.98° and 24.42° for main and secondary curves. Statistical analysis showed improved correction rates in patients operated with CoCr rods for main (P < 0.0001) and secondary (P = 0.0003) curves with a lower loss of correction at final follow-up. Regarding the sagittal profile, postoperative T4T12 thoracic kyphosis was 28.04° in CoCr group compared to 22.79° in SS group (P = 0. 0.0038).

Discussion

The present study confirms the ability of the all-pedicle screw construct to reach the maximum coronal plane correction and prevent deformity progression while maintaining balance. CoCr rods have the ability to exert higher corrective forces on the spine with relatively small amounts of rod deformation. Our findings confirm that CoCr rods have the ability to produce higher correction rates in frontal plane compared to SS rods of the same diameter.
Literature
1.
go back to reference Hitchon PW, Brenton MD, Black AG, From A, Harrod JS, Barry C, Serhan H, Torner JC (2003) In vitro biomechanical comparison of pedicle screws, sublaminar hooks, and sublaminar cables. J Neurosurg 99:104–109PubMed Hitchon PW, Brenton MD, Black AG, From A, Harrod JS, Barry C, Serhan H, Torner JC (2003) In vitro biomechanical comparison of pedicle screws, sublaminar hooks, and sublaminar cables. J Neurosurg 99:104–109PubMed
2.
go back to reference Kim YJ, Lenke LG, Cho SK, Bridwell KH, Sides B, Blanke K (2004) Comparative analysis of pedicle screw versus hook instrumentation in posterior spinal fusion of adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 29:2040–2048CrossRef Kim YJ, Lenke LG, Cho SK, Bridwell KH, Sides B, Blanke K (2004) Comparative analysis of pedicle screw versus hook instrumentation in posterior spinal fusion of adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 29:2040–2048CrossRef
3.
go back to reference Karatoprak O, Unay K, Tezer M, Ozturk C, Aydogan M, Mirzanli C (2008) Comparative analysis of pedicle screw versus hybrid instrumentation in adolescent idiopathic scoliosis surgery. Int Orthop 32:523–528 discussion 529PubMedCentralPubMedCrossRef Karatoprak O, Unay K, Tezer M, Ozturk C, Aydogan M, Mirzanli C (2008) Comparative analysis of pedicle screw versus hybrid instrumentation in adolescent idiopathic scoliosis surgery. Int Orthop 32:523–528 discussion 529PubMedCentralPubMedCrossRef
4.
go back to reference Kim YJ, Lenke LG, Kim J, Bridwell KH, Cho SK, Cheh G, Sides B (2006) Comparative analysis of pedicle screw versus hybrid instrumentation in posterior spinal fusion of adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 31:291–298CrossRef Kim YJ, Lenke LG, Kim J, Bridwell KH, Cho SK, Cheh G, Sides B (2006) Comparative analysis of pedicle screw versus hybrid instrumentation in posterior spinal fusion of adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 31:291–298CrossRef
5.
go back to reference Lowenstein JE, Matsumoto H, Vitale MG, Weidenbaum M, Gomez JA, Lee FY, Hyman JE, Roye DP Jr (2007) Coronal and sagittal plane correction in adolescent idiopathic scoliosis: a comparison between all pedicle screw versus hybrid thoracic hook lumbar screw constructs. Spine (Phila Pa 1976) 32:448–452CrossRef Lowenstein JE, Matsumoto H, Vitale MG, Weidenbaum M, Gomez JA, Lee FY, Hyman JE, Roye DP Jr (2007) Coronal and sagittal plane correction in adolescent idiopathic scoliosis: a comparison between all pedicle screw versus hybrid thoracic hook lumbar screw constructs. Spine (Phila Pa 1976) 32:448–452CrossRef
6.
go back to reference Sugarman E, Sarwahi V, Amaral T, Wollowick A, Gambassi M, Seimon L (2013) Comparative analysis of perioperative differences between hybrid versus pedicle screw instrumentation in adolescent idiopathic scoliosis. J Spinal Disord Tech 26:161–166PubMedCrossRef Sugarman E, Sarwahi V, Amaral T, Wollowick A, Gambassi M, Seimon L (2013) Comparative analysis of perioperative differences between hybrid versus pedicle screw instrumentation in adolescent idiopathic scoliosis. J Spinal Disord Tech 26:161–166PubMedCrossRef
7.
go back to reference Belmont PJ Jr, Polly DW, Jr, Cunningham BW, Klemme WR (2001) The effects of hook pattern and kyphotic angulation on mechanical strength and apical rod strain in a long-segment posterior construct using a synthetic model. Spine (Phila Pa 1976) 26:627–635CrossRef Belmont PJ Jr, Polly DW, Jr, Cunningham BW, Klemme WR (2001) The effects of hook pattern and kyphotic angulation on mechanical strength and apical rod strain in a long-segment posterior construct using a synthetic model. Spine (Phila Pa 1976) 26:627–635CrossRef
8.
go back to reference Clements DH, Betz RR, Newton PO, Rohmiller M, Marks MC, Bastrom T (2009) Correlation of scoliosis curve correction with the number and type of fixation anchors. Spine (Phila Pa 1976) 34:2147–2150CrossRef Clements DH, Betz RR, Newton PO, Rohmiller M, Marks MC, Bastrom T (2009) Correlation of scoliosis curve correction with the number and type of fixation anchors. Spine (Phila Pa 1976) 34:2147–2150CrossRef
9.
go back to reference Serhan H, Mhatre D, Newton P, Giorgio P, Sturm P (2013) Would CoCr rods provide better correctional forces than stainless steel or titanium for rigid scoliosis curves? J Spinal Disord Tech 26:E70–E74PubMedCrossRef Serhan H, Mhatre D, Newton P, Giorgio P, Sturm P (2013) Would CoCr rods provide better correctional forces than stainless steel or titanium for rigid scoliosis curves? J Spinal Disord Tech 26:E70–E74PubMedCrossRef
10.
go back to reference Wedemeyer M, Parent S, Mahar A, Odell T, Swimmer T, Newton P (2007) Titanium versus stainless steel for anterior spinal fusions: an analysis of rod stress as a predictor of rod breakage during physiologic loading in a bovine model. Spine (Phila Pa 1976) 32:42–48CrossRef Wedemeyer M, Parent S, Mahar A, Odell T, Swimmer T, Newton P (2007) Titanium versus stainless steel for anterior spinal fusions: an analysis of rod stress as a predictor of rod breakage during physiologic loading in a bovine model. Spine (Phila Pa 1976) 32:42–48CrossRef
11.
go back to reference Abul-Kasim K, Karlsson MK, Ohlin A (2011) A increased rod stiffness improves the degree of deformity correction by segmental pedicle screw fixation in adolescent idiopathic scoliosis. Scoliosis 6:13PubMedCentralPubMedCrossRef Abul-Kasim K, Karlsson MK, Ohlin A (2011) A increased rod stiffness improves the degree of deformity correction by segmental pedicle screw fixation in adolescent idiopathic scoliosis. Scoliosis 6:13PubMedCentralPubMedCrossRef
12.
go back to reference Lamartina C, Petruzzi M, Macchia M, Stradiotti P, Zerbi A (2011) A role of rod diameter in comparison between only screws versus hooks and screws in posterior instrumentation of thoracic curve in idiopathic scoliosis. Eur Spine J 20(Suppl 1):S85–S89PubMedCrossRef Lamartina C, Petruzzi M, Macchia M, Stradiotti P, Zerbi A (2011) A role of rod diameter in comparison between only screws versus hooks and screws in posterior instrumentation of thoracic curve in idiopathic scoliosis. Eur Spine J 20(Suppl 1):S85–S89PubMedCrossRef
13.
go back to reference Lenke LG, Betz RR, Harms J, Bridwell KH, Clements DH, Lowe TG, Blanke K (2001) Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis. J Bone Joint Surg Am 83(A(8)):1169–1181PubMed Lenke LG, Betz RR, Harms J, Bridwell KH, Clements DH, Lowe TG, Blanke K (2001) Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis. J Bone Joint Surg Am 83(A(8)):1169–1181PubMed
14.
go back to reference Asher MA, Lai SM, Carlson BB, Gum JL, Burton DC (2010) Transverse plane pelvic rotation increase (TPPRI) following rotationally corrective instrumentation of adolescent idiopathic scoliosis double curves. Scoliosis 5:18PubMedCentralPubMedCrossRef Asher MA, Lai SM, Carlson BB, Gum JL, Burton DC (2010) Transverse plane pelvic rotation increase (TPPRI) following rotationally corrective instrumentation of adolescent idiopathic scoliosis double curves. Scoliosis 5:18PubMedCentralPubMedCrossRef
16.
go back to reference Crawford AH, Lykissas MG, Gao X, Eismann E, Anadio J (2013) All-pedicle screw versus hybrid instrumentation in adolescent idiopathic scoliosis surgery: a comparative radiographical study with a minimum 2-year follow-up. Spine (Phila Pa 1976) 38:1199–1208CrossRef Crawford AH, Lykissas MG, Gao X, Eismann E, Anadio J (2013) All-pedicle screw versus hybrid instrumentation in adolescent idiopathic scoliosis surgery: a comparative radiographical study with a minimum 2-year follow-up. Spine (Phila Pa 1976) 38:1199–1208CrossRef
17.
go back to reference Cuartas E, Rasouli A, O’Brien M, Shufflebarger HL (2009) Use of all-pedicle-screw constructs in the treatment of adolescent idiopathic scoliosis. J Am Acad Orthop Surg 17:550–561PubMed Cuartas E, Rasouli A, O’Brien M, Shufflebarger HL (2009) Use of all-pedicle-screw constructs in the treatment of adolescent idiopathic scoliosis. J Am Acad Orthop Surg 17:550–561PubMed
18.
go back to reference Quan GM, Gibson MJ (2010) Correction of main thoracic adolescent idiopathic scoliosis using pedicle screw instrumentation: does higher implant density improve correction? Spine (Phila Pa 1976) 35:562–567CrossRef Quan GM, Gibson MJ (2010) Correction of main thoracic adolescent idiopathic scoliosis using pedicle screw instrumentation: does higher implant density improve correction? Spine (Phila Pa 1976) 35:562–567CrossRef
19.
go back to reference Rose PS, Lenke LG, Bridwell KH, Mulconrey DS, Cronen GA, Buchowski JM, Schwend RM, Sides BA (2009) Pedicle screw instrumentation for adult idiopathic scoliosis: an improvement over hook/hybrid fixation. Spine (Phila Pa 1976) 34:852–857 discussion 858CrossRef Rose PS, Lenke LG, Bridwell KH, Mulconrey DS, Cronen GA, Buchowski JM, Schwend RM, Sides BA (2009) Pedicle screw instrumentation for adult idiopathic scoliosis: an improvement over hook/hybrid fixation. Spine (Phila Pa 1976) 34:852–857 discussion 858CrossRef
21.
go back to reference Hwang SW, Samdani AF, Marks M, Bastrom T, Garg H, Lonner B, Bennett JT, Pahys J, Shah S, Miyanji F, Shufflebarger H, Newton P, Betz R (2013) Five-year clinical and radiographic outcomes using pedicle screw only constructs in the treatment of adolescent idiopathic scoliosis. Eur Spine J 22:1292–1299. doi:10.1007/s00586-012-2625-0 PubMedCentralPubMedCrossRef Hwang SW, Samdani AF, Marks M, Bastrom T, Garg H, Lonner B, Bennett JT, Pahys J, Shah S, Miyanji F, Shufflebarger H, Newton P, Betz R (2013) Five-year clinical and radiographic outcomes using pedicle screw only constructs in the treatment of adolescent idiopathic scoliosis. Eur Spine J 22:1292–1299. doi:10.​1007/​s00586-012-2625-0 PubMedCentralPubMedCrossRef
22.
go back to reference Noshchenko A, Xianfeng Y, Armour GA, Baldini T, Patel VV, Ayers R, Burger E (2011) Evaluation of spinal instrumentation rod bending characteristics for in situ contouring. J Biomed Mater Res B Appl Biomater 98:192–200PubMedCrossRef Noshchenko A, Xianfeng Y, Armour GA, Baldini T, Patel VV, Ayers R, Burger E (2011) Evaluation of spinal instrumentation rod bending characteristics for in situ contouring. J Biomed Mater Res B Appl Biomater 98:192–200PubMedCrossRef
23.
go back to reference Paik H, Kang DG, Lehman RA Jr, Gaume RE, Ambati DV, Dmitriev AE (2013) The biomechanical consequences of rod reduction on pedicle screws: should it be avoided? Spine J 13:1617–1626. pii: S1529-9430(13)00522-6PubMedCrossRef Paik H, Kang DG, Lehman RA Jr, Gaume RE, Ambati DV, Dmitriev AE (2013) The biomechanical consequences of rod reduction on pedicle screws: should it be avoided? Spine J 13:1617–1626. pii: S1529-9430(13)00522-6PubMedCrossRef
24.
go back to reference Noshchenko A, Patel VV, Baldini T, Yun L, Lindley EM, Burger EL (2011) Thermomechanical effects of spine surgery rods composed of different metals and alloys. Spine (Phila Pa 1976) 36:870–878CrossRef Noshchenko A, Patel VV, Baldini T, Yun L, Lindley EM, Burger EL (2011) Thermomechanical effects of spine surgery rods composed of different metals and alloys. Spine (Phila Pa 1976) 36:870–878CrossRef
25.
go back to reference Isa Majluf M (1991) The use of hydroxyapatite in modern dentistry. Rev Dent Chile 82:30–35PubMed Isa Majluf M (1991) The use of hydroxyapatite in modern dentistry. Rev Dent Chile 82:30–35PubMed
26.
go back to reference Harnach Z (1958) Inertium-a Czechoslovakian alloy with the properties of vitalium. Acta Chir Orthop Traumatol Cech 25:23–27PubMed Harnach Z (1958) Inertium-a Czechoslovakian alloy with the properties of vitalium. Acta Chir Orthop Traumatol Cech 25:23–27PubMed
27.
go back to reference Mollowitz G (1966) Vitalium endprosthesis in sarcoma of the proximal humerus. Chirurg 37:130–132PubMed Mollowitz G (1966) Vitalium endprosthesis in sarcoma of the proximal humerus. Chirurg 37:130–132PubMed
28.
go back to reference Radulescu A, Stanciulescu P, Voinea A, Robanescu N, Baciu C, Radulescu M (1957) Comparative aspects of biological tolerance of acrylic and vitalium implants. Probl Tuberculoza 7:81–86PubMed Radulescu A, Stanciulescu P, Voinea A, Robanescu N, Baciu C, Radulescu M (1957) Comparative aspects of biological tolerance of acrylic and vitalium implants. Probl Tuberculoza 7:81–86PubMed
29.
go back to reference Wojnar L (2001) Porosity structure and mechanical properties of vitalium-type alloy for implants. Mater Charact 46:221CrossRef Wojnar L (2001) Porosity structure and mechanical properties of vitalium-type alloy for implants. Mater Charact 46:221CrossRef
30.
go back to reference Yu CH, Chen PQ, Ma SC, Pan CH (2012) Segmental correction of adolescent idiopathic scoliosis by all-screw fixation method in adolescents and young adults. Minimum 5 years follow-up with SF-36 questionnaire. Scoliosis 7:5PubMedCentralPubMedCrossRef Yu CH, Chen PQ, Ma SC, Pan CH (2012) Segmental correction of adolescent idiopathic scoliosis by all-screw fixation method in adolescents and young adults. Minimum 5 years follow-up with SF-36 questionnaire. Scoliosis 7:5PubMedCentralPubMedCrossRef
31.
go back to reference Ernstberger T, Heidrich G (2007) Postfusion magnetic resonance imaging artifacts caused by a titanium, cobalt–chromium–molybdenum, and carbon intervertebral disc spacer. J Spinal Disord Tech 20:154–159PubMedCrossRef Ernstberger T, Heidrich G (2007) Postfusion magnetic resonance imaging artifacts caused by a titanium, cobalt–chromium–molybdenum, and carbon intervertebral disc spacer. J Spinal Disord Tech 20:154–159PubMedCrossRef
32.
go back to reference Trammell TR, Flint K, Ramsey CJ (2012) A comparison of MRI and CT imaging clarity of titanium alloy and titanium alloy with cobalt–chromium-alloy pedicle screw and rod implants in the lumbar spine. J Bone Joint Surg Am 94:1479–1483PubMedCrossRef Trammell TR, Flint K, Ramsey CJ (2012) A comparison of MRI and CT imaging clarity of titanium alloy and titanium alloy with cobalt–chromium-alloy pedicle screw and rod implants in the lumbar spine. J Bone Joint Surg Am 94:1479–1483PubMedCrossRef
33.
go back to reference Scuderi GJ, Greenberg SS, Cohen DS, Latta LL, Eismont FJ (1993) A biomechanical evaluation of magnetic resonance imaging-compatible wire in cervical spine fixation. Spine (Phila Pa 1976) 18:1991–1994CrossRef Scuderi GJ, Greenberg SS, Cohen DS, Latta LL, Eismont FJ (1993) A biomechanical evaluation of magnetic resonance imaging-compatible wire in cervical spine fixation. Spine (Phila Pa 1976) 18:1991–1994CrossRef
34.
go back to reference Griffin CD, Buchanan RA, Lemons JE (1983) In vitro electrochemical corrosion study of coupled surgical implant materials. J Biomed Mater Res 17:489–500PubMedCrossRef Griffin CD, Buchanan RA, Lemons JE (1983) In vitro electrochemical corrosion study of coupled surgical implant materials. J Biomed Mater Res 17:489–500PubMedCrossRef
35.
go back to reference Kuraishi S, Takahashi J, Hirabayashi H, Hashidate H, Ogihara N, Mukaiyama K, Kato H (2013) Pedicle morphology using computed tomography-based navigation system in adolescent idiopathic scoliosis. J Spinal Disord Tech 26:22–28PubMedCrossRef Kuraishi S, Takahashi J, Hirabayashi H, Hashidate H, Ogihara N, Mukaiyama K, Kato H (2013) Pedicle morphology using computed tomography-based navigation system in adolescent idiopathic scoliosis. J Spinal Disord Tech 26:22–28PubMedCrossRef
36.
go back to reference Smorgick Y, Settecerri JJ, Baker KC, Herkowitz H, Fischgrund JS, Zaltz I (2012) Spinal cord position in adolescent idiopathic scoliosis. J Pediatr Orthop 32:500–503PubMedCrossRef Smorgick Y, Settecerri JJ, Baker KC, Herkowitz H, Fischgrund JS, Zaltz I (2012) Spinal cord position in adolescent idiopathic scoliosis. J Pediatr Orthop 32:500–503PubMedCrossRef
38.
go back to reference Takeshita K, Maruyama T, Sugita S, Oshima Y, Morii J, Chikuda H, Ono T, Nakamura K (2011) Is a right pedicle screw always away from the aorta in scoliosis? Spine (Phila Pa 1976) 36:E1519–E1524CrossRef Takeshita K, Maruyama T, Sugita S, Oshima Y, Morii J, Chikuda H, Ono T, Nakamura K (2011) Is a right pedicle screw always away from the aorta in scoliosis? Spine (Phila Pa 1976) 36:E1519–E1524CrossRef
39.
go back to reference Zhu F, Sun X, Qiao J, Ding Y, Zhang B, Qiu Y (2013) Misplacement pattern of pedicle screws in pediatric patients with spinal deformity: a computed tomography study. J Spinal Disord Tech 5. doi:10.1097/BSD.0b013e31828d6a1b Zhu F, Sun X, Qiao J, Ding Y, Zhang B, Qiu Y (2013) Misplacement pattern of pedicle screws in pediatric patients with spinal deformity: a computed tomography study. J Spinal Disord Tech 5. doi:10.​1097/​BSD.​0b013e31828d6a1b​
40.
go back to reference Di Silvestre M, Parisini P, Lolli F, Bakaloudis G (2007) Complications of thoracic pedicle screws in scoliosis treatment. Spine (Phila Pa 1976) 32:1655–1661CrossRef Di Silvestre M, Parisini P, Lolli F, Bakaloudis G (2007) Complications of thoracic pedicle screws in scoliosis treatment. Spine (Phila Pa 1976) 32:1655–1661CrossRef
41.
go back to reference Hicks JM, Singla A, Shen FH, Arlet V (2010) Complications of pedicle screw fixation in scoliosis surgery: a systematic review. Spine (Phila Pa 1976) 35:E465–E470CrossRef Hicks JM, Singla A, Shen FH, Arlet V (2010) Complications of pedicle screw fixation in scoliosis surgery: a systematic review. Spine (Phila Pa 1976) 35:E465–E470CrossRef
42.
go back to reference Kim WJ, Lee SM, Kim JH, Chung ER (2001) Thoracic pedicle screw fixation in spinal deformities: are they really safe? Spine (Phila Pa 1976) 26:2049–2057CrossRef Kim WJ, Lee SM, Kim JH, Chung ER (2001) Thoracic pedicle screw fixation in spinal deformities: are they really safe? Spine (Phila Pa 1976) 26:2049–2057CrossRef
43.
go back to reference Bachy M, Bouyer B, Vialle R (2012) Infections after spinal correction and fusion for spinal deformities in childhood and adolescence. Int Orthop 36:465–469PubMedCentralPubMedCrossRef Bachy M, Bouyer B, Vialle R (2012) Infections after spinal correction and fusion for spinal deformities in childhood and adolescence. Int Orthop 36:465–469PubMedCentralPubMedCrossRef
44.
go back to reference Liljenqvist U, Lepsien U, Hackenberg L, Niemeyer T, Halm H (2002) Comparative analysis of pedicle screw and hook instrumentation in posterior correction and fusion of idiopathic thoracic scoliosis. Eur Spine J 11:336–343PubMedCentralPubMedCrossRef Liljenqvist U, Lepsien U, Hackenberg L, Niemeyer T, Halm H (2002) Comparative analysis of pedicle screw and hook instrumentation in posterior correction and fusion of idiopathic thoracic scoliosis. Eur Spine J 11:336–343PubMedCentralPubMedCrossRef
45.
go back to reference Ledonio CG, Polly DW Jr, Vitale MG, Wang Q, Richards BS (2011) Pediatric pedicle screws: comparative effectiveness and safety: a systematic literature review from the Scoliosis Research Society and the Pediatric Orthopaedic Society of North America task force. J Bone Joint Surg Am 93:1227–1234PubMedCrossRef Ledonio CG, Polly DW Jr, Vitale MG, Wang Q, Richards BS (2011) Pediatric pedicle screws: comparative effectiveness and safety: a systematic literature review from the Scoliosis Research Society and the Pediatric Orthopaedic Society of North America task force. J Bone Joint Surg Am 93:1227–1234PubMedCrossRef
46.
go back to reference Halm H, Niemeyer T, Link T, Liljenqvist U (2000) Segmental pedicle screw instrumentation in idiopathic thoracolumbar and lumbar scoliosis. Eur Spine J 9:191–197PubMedCentralPubMedCrossRef Halm H, Niemeyer T, Link T, Liljenqvist U (2000) Segmental pedicle screw instrumentation in idiopathic thoracolumbar and lumbar scoliosis. Eur Spine J 9:191–197PubMedCentralPubMedCrossRef
47.
go back to reference Min K, Sdzuy C, Farshad M (2013) Posterior correction of thoracic adolescent idiopathic scoliosis with pedicle screw instrumentation: results of 48 patients with minimal 10-year follow-up. Eur Spine J 22:345–354PubMedCentralPubMedCrossRef Min K, Sdzuy C, Farshad M (2013) Posterior correction of thoracic adolescent idiopathic scoliosis with pedicle screw instrumentation: results of 48 patients with minimal 10-year follow-up. Eur Spine J 22:345–354PubMedCentralPubMedCrossRef
Metadata
Title
CoCr rods provide better frontal correction of adolescent idiopathic scoliosis treated by all-pedicle screw fixation
Authors
Mayalen Lamerain
Manon Bachy
Marion Delpont
Reda Kabbaj
Pierre Mary
Raphaël Vialle
Publication date
01-06-2014
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 6/2014
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-014-3168-3

Other articles of this Issue 6/2014

European Spine Journal 6/2014 Go to the issue