scholarly journals Clinical and radiologic outcomes and pulmonary functions after vertebral body tethering for immature adolescent idiopathic scoliosis: Minimum 2 years follow up

2021 ◽  
Vol 1 ◽  
pp. 100149
Author(s):  
Mustafa Eltayep ◽  
Sinan Kahraman ◽  
Ahmet Ates ◽  
Recep Dincer ◽  
Sina Coskun ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Vertebral Body ◽  
Pulmonary Functions

The effect of brace treatment on pulmonary functions in adolescent idiopathic scoliosis: An 8-month follow-up study

2021 ◽  
pp. 1-7
Author(s):  
Yasin Yurt ◽  
İlker Yatar ◽  
Mehtap Malkoç ◽  
Yavuz Yakut ◽  
Serpil Mıhçıoğlu ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Vital Capacity ◽  
Forced Expiratory Volume ◽  
Pulmonary Functions ◽  
Measurement Results ◽  
Forced Expiratory Flow ◽  
Permanent Effect ◽  
Expiratory Flow

BACKGROUND: The instant effect of a brace on pulmonary functions of patients with adolescent idiopathic scoliosis (AIS) is known. However, the permanent effects of its regular use are still unclear. OBJECTIVE: This study aimed to determine whether a brace in patients with AIS had a permanent effect on respiratory functions. METHODS: Fifteen patients with a mean age of 13.2 ± 1.6 years, and a major Cobb angle of 25.8∘± 7.7∘ participated in this study. Lung volumes and respiratory muscle strength were measured with and without thoracolumbosacral brace, at the end of first month and follow-up period after the patients started using the brace for 23 hours daily. RESULTS: When the brace was on, the forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), ratio of FEV1/FVC, peak expiratory flow, and forced expiratory flow between 25% and 75% of vital capacity values were found to be lower at both first month and follow-up. After the follow-up, the measurement results did not differ from the results of the first month. CONCLUSIONS: The brace had a momentary restrictive effect on patients with AIS. However, it did not cause a permanent change in pulmonary functions after the 8-month follow-up.

Upper instrumented vertebra to the right of the lowest instrumented vertebra as a predictor of an increase in the main thoracic curve after selective posterior fusion for the thoracolumbar/lumbar curve in Lenke type 5C adolescent idiopathic scoliosis: multicenter study on the relationship between fusion area and surgical outcome

2019 ◽  
Vol 31 (6) ◽  
pp. 857-864 ◽  
Author(s):  
Hiroki Oba ◽  
Jun Takahashi ◽  
Sho Kobayashi ◽  
Tetsuro Ohba ◽  
Shota Ikegami ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Cobb Angle ◽  
Posterior Fusion ◽  
Main Thoracic ◽  
Lowest Instrumented Vertebra ◽  
Line Tilt ◽  
The Right ◽  
Upper Instrumented Vertebra

OBJECTIVEUnfused main thoracic (MT) curvatures occasionally increase after selective thoracolumbar/lumbar (TL/L) fusion. This study sought to identify the predictors of an unacceptable increase in MT curve (UIMT) after selective posterior fusion (SPF) of the TL/L curve in patients with Lenke type 5C adolescent idiopathic scoliosis (AIS).METHODSForty-eight consecutive patients (44 females and 4 males, mean age 15.7 ± 2.5 years, range 13–24 years) with Lenke type 5C AIS who underwent SPF of the TL/L curve were analyzed. The novel “Shinshu line” (S-line) was defined as a line connecting the centers of the concave-side pedicles of the upper instrumented vertebra (UIV) and lowest instrumented vertebra (LIV) on preoperative radiographs. The authors established an S-line tilt to the right as S-line positive (S-line+, i.e., the UIV being to the right of the LIV) and compared S-line+ and S-line− groups for thoracic apical vertebral translation (T-AVT) and MT Cobb angle preoperatively, early postoperatively, and at final follow-up. The predictors for T-AVT > 20 mm at final follow-up were evaluated as well. T-AVT > 20 mm was defined as a UIMT.RESULTSAmong the 48 consecutively treated patients, 26 were S-line+ and 22 were S-line−. At preoperative, early postoperative, and final follow-up a minimum of 2 years later, the mean T-AVT was 12.8 mm (range −9.3 to 32.8 mm), 19.6 mm (range −13.0 to 41.0 mm), and 22.8 mm (range −1.9 to 68.7 mm) in the S-line+ group, and 10.8 mm (range −5.1 to 27.3 mm), 16.2 mm (range −11.7 to 42.1 mm), and 11.0 mm (range −6.3 to 26.9 mm) in the S-line− group, respectively. T-AVT in S-line+ patients was significantly larger than that in S-line− patients at the final follow-up. Multivariate analysis revealed S-line+ (odds ratio [OR] 23.8, p = 0.003) and preoperative MT Cobb angle (OR 7.9, p = 0.001) to be predictors of a UIMT.CONCLUSIONSS-line+ was defined as the UIV being to the right of the LIV. T-AVT in the S-line+ group was significantly larger than in the S-line− group at the final follow-up. S-line+ status and larger preoperative MT Cobb angle were independent predictors of a UIMT after SPF for the TL/L curve in patients with Lenke type 5C AIS. Surgeons should consider changing the UIV and/or LIV in patients exhibiting S-line+ during preoperative planning to avoid a possible increase in MT curve and revision surgery.

Is Routine Postoperative Radiologic Follow-up Justified in Adolescent Idiopathic Scoliosis?

2013 ◽  
Vol 1 (3) ◽  
pp. 223-228 ◽  
Author(s):  
Alba Vila-Casademunt ◽  
Ferran Pellisé ◽  
Montse Domingo-Sàbat ◽  
Juan Bagó ◽  
Antonia Matamalas ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis

Should L3 be selected as the lowest instrumented vertebra in patients with Lenke type 5C adolescent idiopathic scoliosis whose lowest end vertebra is L4?

2021 ◽  
pp. 1-10
Author(s):  
Tomohiro Banno ◽  
Yu Yamato ◽  
Hiroki Oba ◽  
Tetsuro Ohba ◽  
Tomohiko Hasegawa ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Curve Progression ◽  
Global Alignment ◽  
Fusion Surgery ◽  
Radiographic Outcomes ◽  
Lowest Instrumented Vertebra ◽  
Upper Instrumented Vertebra ◽  
Coronal Decompensation

OBJECTIVE L3 is most often selected as the lowest instrumented vertebra (LIV) to conserve mobile segments in fusion surgery; however, in cases with the lowest end vertebra (LEV) at L4, LIV selection as L3 could have a potential risk of correction loss and coronal decompensation. This study aimed to compare the clinical and radiographic outcomes depending on the LEV in adolescent idiopathic scoliosis (AIS) patients with Lenke type 5C curves. METHODS Data from 49 AIS patients with Lenke type 5C curves who underwent selective thoracolumbar/lumbar (TL/L) fusion to L3 as the LIV were retrospectively analyzed. The patients were classified according to their LEVs into L3 and L4 groups. In the L4 group, subanalysis was performed according to the upper instrumented vertebra (UIV) level toward the upper end vertebra (UEV and 1 level above the UEV [UEV+1] subgroups). Radiographic parameters and clinical outcomes were compared between these groups. RESULTS Among 49 patients, 32 and 17 were in the L3 and L4 groups, respectively. The L4 group showed a lower TL/L curve correction rate and a higher subjacent disc angle postoperatively than the L3 group. Although no intergroup difference was observed in coronal balance (CB), the L4 group showed a significantly higher main thoracic (MT) and TL/L curve progression during the postoperative follow-up period than the L3 group. In the L4 group, the UEV+1 subgroup showed a higher absolute value of CB at 2 years than the UEV subgroup. CONCLUSIONS In Lenke type 5C AIS patients with posterior selective TL/L fusion to L3 as the LIV, patients with their LEVs at L4 showed postoperative MT and TL/L curve progression; however, no significant differences were observed in global alignment and clinical outcome.

Preoperative pelvic obliquity: possible relation to postoperative coronal decompensation in thoracolumbar/lumbar adolescent idiopathic scoliosis

2021 ◽  
pp. 1-10
Author(s):  
Tomohiro Banno ◽  
Yu Yamato ◽  
Hiroki Oba ◽  
Tetsuro Ohba ◽  
Tomohiko Hasegawa ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Clinical Outcomes ◽  
Pelvic Obliquity ◽  
Posterior Fusion ◽  
Lumbar Curve ◽  
Fusion Surgery ◽  
The Right ◽  
Coronal Decompensation

OBJECTIVE Pelvic obliquity is frequently observed in patients with adolescent idiopathic scoliosis with thoracolumbar/lumbar (TL/L) curve. This study aimed to assess pelvic obliquity changes and their effects on clinical outcomes of posterior fusion surgery. METHODS Data in 80 patients (69 with type 5C and 11 with type 6C adolescent idiopathic scoliosis) who underwent posterior fusion surgery were retrospectively analyzed. Pelvic obliquity was defined as an absolute pelvic obliquity angle (POA) value of ≥ 3°. The patients were divided into groups according to preoperative pelvic obliquity. Moreover, patients with preoperative pelvic obliquity were divided based on POA change from preoperative values versus 2 years postoperatively. Patients were divided based on the presence of selective or nonselective TL/L fusion. Radiographic parameters and clinical outcomes were compared between these groups. RESULTS Among 80 patients, 41 (51%) showed preoperative pelvic obliquity, and its direction was upward to the right for all cases. Coronal decompensation 2 years postoperatively was significantly elevated in patients with preoperative pelvic obliquity (p < 0.05). Thirty-two patients (40%) displayed pelvic obliquity 2 years postoperatively. Among 41 patients with preoperative pelvic obliquity, 22 patients (54%) were in the group with a decrease in POA, and 19 were in the group with no decrease. The group with no decrease in POA showed significant TL/L curve progression throughout the postoperative follow-up period. The patients with nonselective fusion showed a significantly lower incidence of pelvic obliquity at 2 years postoperatively. CONCLUSIONS Postoperative coronal decompensation more frequently occurred in patients with preoperative pelvic obliquity than in those without pelvic obliquity preoperatively. In addition, postoperative pelvic obliquity changes may be related to residual lumbar curve behavior.

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