Intermittent pedicle screw application provides better kyphosis restoration in adolescent idiopathic scoliosis for Lenke type 1 and type 2 curves.

PURPOSE: There is still no consensus on the optimum pedicle screw density required for the desired thoracic kyphosis restoration in adolescent idiopathic surgery (AIS). The aim of this study to evaluate the effect of pedicle screw density on thoracic kyphosis restoration in AIS surgery. METHODS: The data of 106 patients from two centers that operated for Lenke type 1 and 2 AIS were retrospectively reviewed. Two groups were constituted according to the pedicle screw density: intermittent pedicle screw constructs (IPSC) (n = 52 patients) and consecutive pedicle screw construct (CPSC) (n = 54 patients) groups. The preoperative and at least 24-month follow-up radiographs and SRS-22 scores were evaluated. The Cobb angle of the main and concomitant curves in the coronal plane and the sagittal plane were measured and compared. RESULTS: The mean follow-up period for the IPSC and CPSC groups was 72.3 ± 37.2 and 62.9 ± 28.8 months, respectively. In the SRS-22 questionnaire, there was no significant difference between the two groups in terms of self-image/appearance domain scores (p = 0.466), but better results were obtained in the IPSC group in terms of treatment satisfaction domain scores (p = 0.010) and better thoracic kyphosis restoration was achieved in IPSC group radiologically for Lenke type 1 curves with - 81.4 ± 81.4% in the IPSC group and 6.8 ± 83.8% in the CPSC group (p < 0.001). CONCLUSION: It was considered that better thoracic kyphosis restoration could be achieved with the less lordotic effect of IPSC in Lenke type 1 curves. Although the current situation had a significant impact on radiological outcomes, its effect on SRS-22 scores was limited.

Effects of hexagonal boron nitride on mechanical properties of bone cement (Polymethylmethacrylate).

OBJECTIVES: The aim of this study was to investigate the effects of adding hexagonal boron nitride at four different concentrations to polymethylmethacrylate (PMMA) bone cement, which is commonly used in orthopedic surgeries, on the mechanical properties and microarchitecture of the bone cement. MATERIALS AND METHODS: The study included an unaltered control group and groups containing four different concentrations (40 g of bone cement with 0.5 g, 1 g, 1.5 g, 2 g) of hexagonal boron nitride. The samples used for mechanical tests were prepared at 20±2ºC in operating room conditions, using molds in accordance with the test standards. As a result of the tests, the pressure values at which the samples deformed were determined from the load-deformation graphs, and the megapascal (MPa) values at which the samples exhibited strength were calculated. RESULTS: The samples with 0.5 g boron added to the bone cement had significantly increased mechanical strength, particularly in the compression test. In the group where 2 g boron was added, it was noted that, compared to the other groups, the strength pressure decreased and the porosity increased. The porosity did not change particularly in the group where 0.5 g boron was added. CONCLUSION: Our study results demonstrate that adding hexagonal boron nitride (HBN) to bone cement at a low concentration (0.5 g / 40 g PPMA) significantly increases the mechanical strength in terms of MPa (compression forces) without adversely affecting porosity. However, the incorporation of HBN at higher concentrations increases porosity, thereby compromising the biomechanical properties of the bone cement, as evidenced by the negative impact on compression and four-point bending tests. Boron-based products have gained increased utilization in the medical field, and HBN is emerging as a promising chemical compound, steadily growing in significance.