Inclusion criteria were: (1) 11 to 17 years old, (2) Risser grade 1 to 4, (3) scoliosis deformity with a double curve defined as Lenke type 6 which has thoracic and lumbar structure curve more than 30 degrees which also satisfying Suk’s guidelines for fusion as a double major curve (4) a minimum follow-up period of 5 years 6, 12. This research was designed as prospective, consecutive, non-randomized study and patients who underwent surgery for scoliosis between 20 were included. With this background, our study was designed to compare and analyze the efficacy of CCM and Ti rod systems with regard to the correction rates of scoliotic curvature in AIS patients with double major curves requiring fusion surgery. However, the benefits of CCM over Ti have only been studied in vitro biomechanical studies so far, with rare clinical studies comparing their correction rates in vivo. Other proposed advantages include relatively low resistance to infection and radiological artifact not significantly different from titanium 9, 10, 11. CCM rods have the merits of both Ti and stainless steel rods, but CCM has higher rigidity than Ti making it possible to use a lower-profile rod with similar strength. Ti rods are subjected to weakening of forces during intra-operative rod contouring and corrective procedures in deformity correction surgeries.Īs the pursuit of the ideal biomaterial continues, use of cobalt-chrome-alloy (CCM) rods has been on the rise. Despite their widespread use, there are concerns about Ti rod implant failure. Ti rods have distinct advantages over their stainless steel predecessors in aspects of more flexibility, a higher inert nature, biocompatibility, corrosion resistance, and an apparent ability to integrate with the surrounding bone with lesser radiologic artifacts 9. Pedicle screw-rod constructs using titanium-alloy (Ti) have become popular in recent years. The pedicle screw-rod system has proven its efficiency due to a strong pull-out force and three-column fixation, and it has become the state-of-art technique for posterior spinal fixation 7, 8. The medical community has been striving continuously to improve available instrumentation to yield better, safer, and stronger implants. Of these two considerations, surgical variables can be controlled and thus are modifiable. ![]() ![]() These goals are affected by factors including patient characteristics (e.g., curve pattern and flexibility) and surgical variables such as the type of device used (hooks or pedicle screws), rod type, and technique used to achieve curve correction (translation, rod-derotation, or direct vertebral rotation) 2, 3, 4, 5, 6. The goals of surgery for adolescent idiopathic scoliosis (AIS) are to correct the deformity and achieve sagittal and coronal balance with fusion of the least number of vertebral segments 1. Biomechanical studies of Ti and CCM rods in vitro is different in biological condition. In conclusion, Ti and CCM rods showed similar correction rates in the sagittal and coronal planes for the surgical correction of AIS with double major curves. There were no significant differences between the two groups in coronal or sagittal factors ( P > 0.05) except for greater postoperative lumbar lordosis in the CCM group ( P < 0.001). In Group A, thoracic and lumbar curvature correction rates were 71.2% and 66.8% respectively, and in Group B they were 71.2% and 73.3%, respectively ( P = 0.664 and 0.09). In our study, there were no significant differences between the two groups with respect to demographics or curve characteristics ( P > 0.05). We measured pre- and postoperative indices of coronal alignment (Cobb’s angle, coronal balance, T1-tilt, clavicle angle) and sagittal alignment (sagittal vertical axis, thoracic kyphosis, lumbar lordosis). The rod-derotation maneuver was used for correction. We divided patients into two groups, Group A (n = 29) treated with six-millimeter Ti rods and Group B (n = 16) treated with six-millimeter CCM rods. We enrolled 45 patients with AIS who underwent surgery between 20. Therefore, the purpose of this study is to compare the correction rates of Ti and CCM rods in the treatment of AIS with double major curves. However, there is a dearth of literature comparing the two rod materials in adolescent idiopathic scoliosis (AIS). ![]() Numerous biomechanical studies comparing titanium (Ti) and cobalt-chrome-alloy (CCM) rods are described in the literature.
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