The Impact of Screw Density on the Outcomes of Adolescent Idiopathic Scoliosis Correction Surgery: A Multicenter Retrospective Study

Background To evaluate the efficacy of low screw density constructs versus high screw density constructs in adolescent idiopathic scoliosis (AIS) surgery.Methods Data were collected from AIS patients who underwent pedicle screw fixation surgery at two medical centers. Patients were stratified into l...

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Main Authors: ZhaoJun Lu, Chong Liu, JiaKun Li, XiaoPeng Qin, Jiarui Chen, Jiang Xue, Hao Li, Tianyou Chen, Tao Chen, XinLi Zhan
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Journal of Investigative Surgery
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Online Access:https://www.tandfonline.com/doi/10.1080/08941939.2025.2531589
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author ZhaoJun Lu
Chong Liu
JiaKun Li
XiaoPeng Qin
Jiarui Chen
Jiang Xue
Hao Li
Tianyou Chen
Tao Chen
XinLi Zhan
author_facet ZhaoJun Lu
Chong Liu
JiaKun Li
XiaoPeng Qin
Jiarui Chen
Jiang Xue
Hao Li
Tianyou Chen
Tao Chen
XinLi Zhan
author_sort ZhaoJun Lu
collection DOAJ
description Background To evaluate the efficacy of low screw density constructs versus high screw density constructs in adolescent idiopathic scoliosis (AIS) surgery.Methods Data were collected from AIS patients who underwent pedicle screw fixation surgery at two medical centers. Patients were stratified into low and high screw density groups, calculated as pedicle screws per fused vertebral level. The dataset comprised demographics, radiological parameters, surgical outcomes and postoperative complications.Results Of 213 AIS patients analyzed, 114 and 99 comprised low- and high-density groups respectively. Compared with high-density constructs, low-density constructs demonstrated shorter operative time (median: 17.93 min, IQR: 14.66–20.50 vs. 22.15 min, IQR: 16.80–24.77; p = 6.30e−07), lower intraoperative blood loss (median: 762.29 ml, IQR: 600–900 vs. 954.19 ml, IQR: 800–1030; p = 7.70e−07), fewer postoperative pain (median: 4.719, IQR: 3–7 vs. 5.505, IQR: 3.5–7; p = 0.009), and shorter hospital stays (median: 11.15 days, IQR: 7–13.5 vs. 12.48 days, IQR: 8–15; p = 0.04). Both groups had equivalent Cobb angle correction (median: 67.31%, IQR: 60.50% –76.84% vs. 67.97%, IQR: 62.54%–73.52%; p = 0.90).Conclusion Optimizing screw density may minimize intraoperative blood loss and postoperative pain without affecting correction efficacy in AIS; however, longitudinal studies are needed to assess long-term functional and quality-of-life outcomes.
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spelling doaj-art-3e450b600276471a97b21aa3c115f91f2025-08-20T03:56:46ZengTaylor & Francis GroupJournal of Investigative Surgery0894-19391521-05532025-12-0138110.1080/08941939.2025.2531589The Impact of Screw Density on the Outcomes of Adolescent Idiopathic Scoliosis Correction Surgery: A Multicenter Retrospective StudyZhaoJun Lu0Chong Liu1JiaKun Li2XiaoPeng Qin3Jiarui Chen4Jiang Xue5Hao Li6Tianyou Chen7Tao Chen8XinLi Zhan9Spine Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of ChinaSpine Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of ChinaSpine Surgery, Yulin Orthopedic Hospital of Integrated Traditional Chinese and Western Medicine, Yulin, Guangxi, People’s Republic of ChinaSpine Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of ChinaSpine Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of ChinaSpine Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of ChinaSpine Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of ChinaSpine Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of ChinaSpine Surgery, Yulin Orthopedic Hospital of Integrated Traditional Chinese and Western Medicine, Yulin, Guangxi, People’s Republic of ChinaSpine Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of ChinaBackground To evaluate the efficacy of low screw density constructs versus high screw density constructs in adolescent idiopathic scoliosis (AIS) surgery.Methods Data were collected from AIS patients who underwent pedicle screw fixation surgery at two medical centers. Patients were stratified into low and high screw density groups, calculated as pedicle screws per fused vertebral level. The dataset comprised demographics, radiological parameters, surgical outcomes and postoperative complications.Results Of 213 AIS patients analyzed, 114 and 99 comprised low- and high-density groups respectively. Compared with high-density constructs, low-density constructs demonstrated shorter operative time (median: 17.93 min, IQR: 14.66–20.50 vs. 22.15 min, IQR: 16.80–24.77; p = 6.30e−07), lower intraoperative blood loss (median: 762.29 ml, IQR: 600–900 vs. 954.19 ml, IQR: 800–1030; p = 7.70e−07), fewer postoperative pain (median: 4.719, IQR: 3–7 vs. 5.505, IQR: 3.5–7; p = 0.009), and shorter hospital stays (median: 11.15 days, IQR: 7–13.5 vs. 12.48 days, IQR: 8–15; p = 0.04). Both groups had equivalent Cobb angle correction (median: 67.31%, IQR: 60.50% –76.84% vs. 67.97%, IQR: 62.54%–73.52%; p = 0.90).Conclusion Optimizing screw density may minimize intraoperative blood loss and postoperative pain without affecting correction efficacy in AIS; however, longitudinal studies are needed to assess long-term functional and quality-of-life outcomes.https://www.tandfonline.com/doi/10.1080/08941939.2025.2531589adolescent idiopathic scoliosisscrew densityradiographicshort-term outcomesAIS
spellingShingle ZhaoJun Lu
Chong Liu
JiaKun Li
XiaoPeng Qin
Jiarui Chen
Jiang Xue
Hao Li
Tianyou Chen
Tao Chen
XinLi Zhan
The Impact of Screw Density on the Outcomes of Adolescent Idiopathic Scoliosis Correction Surgery: A Multicenter Retrospective Study
Journal of Investigative Surgery
adolescent idiopathic scoliosis
screw density
radiographic
short-term outcomes
AIS
title The Impact of Screw Density on the Outcomes of Adolescent Idiopathic Scoliosis Correction Surgery: A Multicenter Retrospective Study
title_full The Impact of Screw Density on the Outcomes of Adolescent Idiopathic Scoliosis Correction Surgery: A Multicenter Retrospective Study
title_fullStr The Impact of Screw Density on the Outcomes of Adolescent Idiopathic Scoliosis Correction Surgery: A Multicenter Retrospective Study
title_full_unstemmed The Impact of Screw Density on the Outcomes of Adolescent Idiopathic Scoliosis Correction Surgery: A Multicenter Retrospective Study
title_short The Impact of Screw Density on the Outcomes of Adolescent Idiopathic Scoliosis Correction Surgery: A Multicenter Retrospective Study
title_sort impact of screw density on the outcomes of adolescent idiopathic scoliosis correction surgery a multicenter retrospective study
topic adolescent idiopathic scoliosis
screw density
radiographic
short-term outcomes
AIS
url https://www.tandfonline.com/doi/10.1080/08941939.2025.2531589
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