ArticleJournal of clinical orthopaedics and trauma2025
The impact of upper instrumented vertebra device type on shoulder balance in Lenke type 1 scoliosis: A comparison of hooks vs. screws.
Article in Journal of clinical orthopaedics and trauma, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
Study design: Retrospective Cohort Study. Objectives: This study aims to evaluate how using hooks versus screws at the upper instrumented vertebra (UIV) influences postoperative shoulder alignment in individuals with Lenke Type 1 adolescent idiopathic scoliosis (AIS). Methods: A total of 61 patients with Lenke Type 1 adolescent idiopathic scoliosis who underwent posterior spinal fusion (PSF) between 2017 and 2022 were analyzed in this retrospective cohort study. Subjects were grouped based on UIV device type: hook or screw. Shoulder imbalance was measured prior to surgery, three days after the procedure, and at the one-year postoperative follow-up using radiologic shoulder height (RSH) as the primary measure. Statistical analysis compared outcomes between the groups. Results: Both hook and screw instrumentation effectively corrected shoulder imbalance. Nonetheless, there were no statistically significant differences between groups in correction outcomes either immediately post-surgery (P = 0.301) or at the one-year follow-up (P = 0.431). Likewise, changes in RSH from preoperative to postoperative and from postoperative to follow-up were not significantly different (P = 0.784 and P = 0.201, respectively). These findings suggest the choice of UIV device does not significantly impact shoulder balance correction in the short to mid-term. Conclusions: Hook and screw constructs appear equally effective in correcting shoulder imbalance in Lenke Type 1 AIS. The choice of instrumentation at the UIV may have minimal influence on shoulder alignment after surgery. Further prospective research involving larger cohorts and extended follow-up durations is needed to validate these results and explore the long-term effects of UIV constructs on shoulder balance.
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