European Spine Journal

, Volume 28, Issue 6, pp 1296–1300 | Cite as

Long-term follow-up after surgical treatment of adolescent idiopathic scoliosis using high-density pedicle screw constructs: Is 5-year routine visit required?

  • Jean-Marc Mac-ThiongEmail author
  • Rodrigo Remondino
  • J. Joncas
  • Stefan Parent
  • Hubert Labelle
Original Article



The objective of this study is to determine whether routine follow-up 5 years after adolescent idiopathic scoliosis (AIS) surgery is likely to affect postoperative care for patients treated with high-density pedicle screw constructs, when routine 2-year follow-up has been performed.


We reviewed 80 patients undergoing surgery for AIS using high-density pedicle screw constructs and followed routinely 2 and 5 years after surgery. Quality of life (QOL) was assessed using the SRS-30 outcome questionnaire. Reoperations occurring between 2 and 5 years after surgery were identified.


Curve correction and QOL were similar between 2- and 5-year visits. Two patients required revision surgery after presenting during unplanned visits between the 2- and 5-year follow-ups. One patient presented at the routine 5-year visit with an asymptomatic undisplaced rod fracture without loss of correction, and it was decided to follow-up only as needed.


In AIS patients for whom routine follow-up 2 years after surgery using high-density pedicle screw constructs was uneventful, additional routine 5-year follow-up is not likely to affect postoperative care and revision rate. Patients developing complications and needing reoperation between 2 and 5 years after surgery will most likely present during unplanned visits rather than during routine follow-up appointments. Easy access to emergent visits on an as-needed basis is therefore important for this population if routine 5-year follow-up is not planned.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.


Adolescent idiopathic scoliosis Quality of life Scoliosis Spinal deformity Spine 


Compliance with ethical standards

Conflict of interest

No funding was received for this research. There is no conflict of interest directly related to this research. JMMT, SP and HL are co-founders and board members of Spinologics Inc. RR and JJ have no competing interests associated with this work.

Supplementary material

586_2019_5887_MOESM1_ESM.pptx (275 kb)
Supplementary material 1 (PPTX 275 kb)


  1. 1.
    Ahmed SI, Bastrom TP, Yaszay B et al (2017) 5-year reoperation risk and causes for revision after idiopathic scoliosis surgery. Spine 42:999–1005CrossRefGoogle Scholar
  2. 2.
    Lonner BS, Ren Y, Yaszay B et al (2018) Evolution of surgery for adolescent idiopathic scoliosis over 20 years: have outcomes improved? Spine 43:402–410Google Scholar
  3. 3.
    Bharucha NJ, Lonner BS, Auerbach JD et al (2013) Low-density versus high-density thoracic pedicle screw constructs in adolescent idiopathic scoliosis: do more screws lead to a better outcome? Spine J 13:375–381CrossRefGoogle Scholar
  4. 4.
    Gebhart S, Alton TB, Bompadre V et al (2014) Do anchor density or pedicle screw density correlate with short-term outcome measures in adolescent idiopathic scoliosis surgery? Spine 39:E104–E110CrossRefGoogle Scholar
  5. 5.
    Li M, Shen Y, Fang X et al (2009) Coronal and sagittal plane correction in patients with Lenke 1 adolescent idiopathic scoliosis. A comparison of consecutive versus interval pedicle screw placement. J Spinal Disord Tech 22:251–256CrossRefGoogle Scholar
  6. 6.
    Quan GMY, Gibson MJ (2010) Correction of main thoracic adolescent idiopathic scoliosis using pedicle screw instrumentation. Does higher implant density improve correction? Spine 35:562–567CrossRefGoogle Scholar
  7. 7.
    Rushton PRP, Elmalky M, Tikoo A et al (2016) The effect of metal density in thoracic adolescent idiopathic scoliosis. Eur Spine J 25:3324–3330CrossRefGoogle Scholar
  8. 8.
    Clements DH, Betz RR, Newton PO et al (2009) Correlation of scoliosis curve correction with the number and type of fixation anchors. Spine 34:2147–2150CrossRefGoogle Scholar
  9. 9.
    Larson AN, Polly DW Jr, Diamond B et al (2014) Does higher anchor density results in increased curve correction and improved clinical outcomes in adolescent idiopathic scoliosis? Spine 39:571–578CrossRefGoogle Scholar
  10. 10.
    Mac-Thiong J-M, Ibrahim S, Parent S et al (2017) Defining the number and type of fixation anchors for optimal main curve correction in posterior surgery for adolescent idiopathic scoliosis. Spine J 17:663–670CrossRefGoogle Scholar
  11. 11.
    Sanders JO, Diab M, Richards SB et al (2011) Fixation points within the main thoracic curve. Does more instrumentation produce greater curve correction and improved results? Spine 36:E1402–E1406CrossRefGoogle Scholar
  12. 12.
    Kuklo TR, Potter BK, Lenke LG et al (2007) Surgical revision rates of hooks versus hybrid versus screws versus combined anteroposterior spinal fusion for adolescent idiopathic scoliosis. Spine 32:2258–2264CrossRefGoogle Scholar
  13. 13.
    Lykissas MG, Jain VV, Nathan ST et al (2013) Mid- to long-term outcomes in adolescent idiopathic scoliosis after instrumented posterior spinal fusion. A meta-analysis. Spine 38:E113–E119CrossRefGoogle Scholar
  14. 14.
    Garg S, Kipper E, LaGreca J et al (2015) Are routine postoperative radiographs necessary during the first year after posterior spinal fusion for idiopathic scoliosis? A retrospective cohort analysis of implant failure and surgery revision rates. J Pediatr Orthop 35:33–38CrossRefGoogle Scholar
  15. 15.
    Hwang SW, Samdani AF, Marks M et al (2013) Five-year clinical and radiographic outcomes using pedicle screw only constructs in the treatment of adolescent idiopathic scoliosis. Eur Spine J 22:1292–1299CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.University of MontrealMontrealCanada
  2. 2.Department of SurgeryCHU Sainte-JustineMontrealCanada
  3. 3.Hôpital du Sacré-CoeurMontrealCanada
  4. 4.Hospital de Pediatra Prof. Dr. Juan P. GarrahanBuenos AiresArgentina

Personalised recommendations