Evidence map›Paper›PMID 40875088›Full record

Trial reportSpine deformity2026

Double claw construct with hooks for proximal fixation in adolescent idiopathic scoliosis: a randomized controlled trial.

J J M Renkens, A Willems, M Reijman, P de Baat, L W L de Klerk, J P H J Rutges

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Spine deformity, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

J J M RenkensDepartment of Orthopedics and Sports Medicine, Erasmus MC Sophia Children's Hospital, University Medical Centre, Dr. Molewaterplein40, 3015 GD, Rotterdam, The Netherlands. j.renkens@erasmusmc.nl.ORCID http://orcid.org/0009-0003-0975-5848
A WillemsDepartment of Orthopedics and Sports Medicine, Erasmus MC Sophia Children's Hospital, University Medical Centre, Dr. Molewaterplein40, 3015 GD, Rotterdam, The Netherlands.ORCID http://orcid.org/0000-0002-0399-7833
M ReijmanDepartment of Orthopedics and Sports Medicine, Erasmus MC Sophia Children's Hospital, University Medical Centre, Dr. Molewaterplein40, 3015 GD, Rotterdam, The Netherlands.ORCID http://orcid.org/0000-0001-6316-9629
P de BaatDepartment of Orthopaedic Surgery and Trauma, Catharina Hospital, Eindhoven, The Netherlands.
L W L de KlerkDepartment of Orthopedics, Sint Maartenskliniek, Ubbergen, The Netherlands.
J P H J RutgesDepartment of Orthopedics and Sports Medicine, Erasmus MC Sophia Children's Hospital, University Medical Centre, Dr. Molewaterplein40, 3015 GD, Rotterdam, The Netherlands.ORCID http://orcid.org/0000-0002-9452-415X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeProximal fixation in adolescent idiopathic scoliosis (AIS) surgery is a matter of discussion. All screw (AS) constructs provide better coronal correction than hybrid constructs, but high thoracic pedicle screw placement can be challenging. This study investigated whether an AS-construct provides better correction than a proximal double hook-claw (PH) construct.

methodsAIS patients undergoing posterior spinal fusion (PSF) were randomized to AS-construct or PH-construct from 2016 to 2020 with a two-year follow-up. Primary outcome is the main thoracic (MT) Cobb angle correction after two years. Secondary outcomes are thoracic kyphosis (TK), proximal junctional angle (PJA), proximal thoracic (PT) Cobb angle, SRS-22r, and complications after two years.

results60 patients (30 AS, 30 PH) were included. No baseline differences were found. Preoperative MT Cobb angle was 62° ± 11° (AS) vs. 65° ± 12° (PH). There was no statistical difference in MT Cobb angle after two years: 25° ± 9° (AS) vs. 27° ± 7° (PH) (p = 0.247). No difference in PT Cobb angle was found: 20° ± 9° (AS) vs. 21° ± 9° (PH) and TK: 23° ± 9° (AS) vs. 22° ± 7° (PH). SRS-22r improved in both groups with no statistical difference: 3.9 ± 0.5 to 4.3 ± 0.5 (AS) vs. 3.7 ± 0.5 to 4.3 ± 0.5 (PH). There were 13 complications (ten patients) in AS group and 17 (13 patients) in PH group, including 1 major complication in each group (deep wound infection).

conclusionAS-construct does not provide better coronal Cobb correction after two years after surgery. A PH-construct is a reliable and safe option for proximal fixation AIS patients. TRN: NTR-NL5552 (2016).

trial registrationOverview of medical research in the Netherlands (OMON): NL-OMON43852.

Indexed as

Pedicle ScrewsScoliosisSpinal FusionAdolescentChildFemaleFollow-Up StudiesHumansKyphosisMaleThoracic VertebraeTreatment OutcomeAdolescentIdiopathicScoliosisSurgical technique

Identifiers

PMID40875088
PMCPMC12815994

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.