scholarly journals Patient-specific rods for thoracic kyphosis correction in adolescent idiopathic scoliosis surgery: Preliminary results

2020 ◽  
Vol 106 (1) ◽  
pp. 159-165 ◽  
Author(s):  
Federico Solla ◽  
Jean-Luc Clément ◽  
Vincent Cunin ◽  
Carlo M. Bertoncelli ◽  
Vincent Fière ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Thoracic Kyphosis ◽  
Patient Specific ◽  
Scoliosis Surgery ◽  
Preliminary Results ◽  
Kyphosis Correction

scholarly journals The correlations between the anchor density and the curve correction of adolescent idiopathic scoliosis surgery

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Yu-Cheng Yeh ◽  
Chi-Chien Niu ◽  
Lih-Huei Chen ◽  
Wen-Jer Chen ◽  
Po-Liang Lai
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Thoracic Kyphosis ◽  
Three Dimensional ◽  
High Density ◽  
Scoliosis Surgery ◽  
Low Density ◽  
Curve Correction ◽  
Kyphosis Correction ◽  
Positive Correlations

Abstract Background The optimal anchor density in adolescent idiopathic scoliosis (AIS) surgery to achieve good curve correction remains unclear. The purpose of the study is to analyze the correlations between three-dimensional curve correction and anchor density in the pedicle screw-based posterior fusion of AIS. Methods One hundred and twenty-seven AIS patients receiving primary posterior fusion with pedicle screw instrumentation were retrospectively reviewed. Anchor density (AD) was defined as the screws number per fused spinal segment. The correlations between three-dimensional curve correction radiographic parameters and anchor density were analyzed with subgroup analysis based on different curve types, curve magnitudes, and curve flexibilities. The differences of curve correction parameters between the low-density (AD ≤1.4), middle-density (1.4 < AD ≤1.7) and high-density (AD > 1.7) groups were also calculated. Independent t-test, analysis of variance (ANOVA), and Pearson’s correlation coefficient were used for statistical analysis. Results There were no correlations between the anchor density and the coronal curve correction or apical vertebral rotation (AVR) correction. In the sagittal plane, mild positive correlations existed between anchor density and thoracic kyphosis correction in all patients (r = 0.27, p = 0.002). Subgroup analysis revealed similar mild positive correlations in Lenke 1 (r = 0.31, p = 0.02), Lenke 1–3 (r = 0.27, p = 0.01), small curves (40°-60°, r = 0.38, p <  0.001), and flexible curves (flexibility > 40%, r = 0.34, p = 0.01). There were no differences between low-density (mean 1.31), middle-density (mean 1.55), and high-density (mean 1.83) in terms of coronal or axial curve correction parameters. Low-density group has longer fused level (mean difference 2.14, p = 0.001) and smaller thoracic kyphosis correction (mean difference 9.25°, p = 0.004) than high-density group. Conclusion In our study, the anchor density was not related to coronal or axial curve corrections. Mild positive correlations with anchor density were found in thoracic kyphosis correction, especially in patients with smaller and flexible curves. Low anchor density with longer fusion level achieves similar curve corrections with middle or high anchor density in adolescent idiopathic scoliosis surgery.

Adolescent idiopathic scoliosis surgery with patient-specific screw placement-guides

2014 ◽  
Vol 23 (12) ◽  
pp. 2765-2766 ◽  
Author(s):  
C. Lamartina ◽  
A. Capuzzo ◽  
R. Cecchinato ◽  
A. Zerbi ◽  
P. Berjano
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Screw Placement ◽  
Patient Specific ◽  
Scoliosis Surgery

scholarly journals Sagittal profile modifications in hybrid versus all screw technique in adolescent idiopathic scoliosis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Laura Scaramuzzo ◽  
Antonino Zagra ◽  
Giuseppe Barone ◽  
Stefano Muzzi ◽  
Leone Minoia ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Cobb Angle ◽  
Thoracic Kyphosis ◽  
Sagittal Alignment ◽  
Vertical Axis ◽  
Sagittal Profile ◽  
Sacral Slope ◽  
Sagittal Vertical Axis ◽  
Lenke Classification

AbstractAim of the study was to evaluate sagittal parameters modifications, with particular interest in thoracic kyphosis, in patients affected by adolescent idiopathic scoliosis (AIS) comparing hybrid and all-screws technique. From June 2010 to September 2018, 145 patients were enrolled. Evaluation included: Lenke classification, Risser scale, coronal Cobb angle, thoracic kyphosis (TK), lumbar lordosis (LL), sagittal vertical axis (SVA), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS). Patients were divided in two groups (1 all-screws and 2 hybrid); a further division, in both groups, was done considering preoperative TK values. Descriptive and inferential statistical analysis was conducted. 99 patients were in group 1, 46 in group 2 (mean follow-up 3.7 years). Patients with a normo-kyphotic profile developed a little variation in TK (Δ pre–post = 2.4° versus − 2.0° respectively). Hyper-kyphotic subgroups had a tendency of restoring a good sagittal alignment. Hypo-kyphotic subgroups, patients treated with all-screw implants developed a higher increase in TK mean Cobb angle (Δ pre–post = 10°) than the hybrid subgroup (Δ pre–post = 5.4°) (p = 0.01). All-screws group showed better results in restoring sagittal alignment in all subgroups compared to hybrid groups, especially in hypo-TK subgroup, with the important advantage to give better correction on coronal plane.

scholarly journals Specific sagittal alignment patterns are already present in mild adolescent idiopathic scoliosis

2021 ◽  
Author(s):  
Tom P. C. Schlösser ◽  
René M. Castelein ◽  
Pierre Grobost ◽  
Suken A. Shah ◽  
Kariman Abelin-Genevois
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Inflection Point ◽  
Thoracic Kyphosis ◽  
Sagittal Alignment ◽  
Three Dimensional ◽  
Sagittal Profile ◽  
Thoracolumbar Kyphosis ◽  
C7 Slope ◽  
Sagittal Malalignment

Abstract Purpose The complex three-dimensional spinal deformity in AIS consists of rotated, lordotic apical areas and neutral junctional zones that modify the spine’s sagittal profile. Recently, three specific patterns of thoracic sagittal ‘malalignment’ were described for severe AIS. The aim of this study is to define whether specific patterns of pathological sagittal alignment are already present in mild AIS. Methods Lateral spinal radiographs of 192 mild (10°–20°) and 253 severe (> 45°) AIS patients and 156 controls were derived from an international consortium. Kyphosis characteristics (T4–T12 thoracic kyphosis, T10–L2 angle, C7 slope, location of the apex of kyphosis and of the inflection point) and sagittal curve types according to Abelin-Genevois were systematically compared between the three cohorts. Results Even in mild thoracic AIS, already 49% of the curves presented sagittal malalignment, mostly thoracic hypokyphosis, whereas only 13% of the (thoraco) lumbar curves and 6% of the nonscoliosis adolescents were hypokyphotic. In severe AIS, 63% had a sagittal malalignment. Hypokyphosis + thoracolumbar kyphosis occurred more frequently in high-PI and primary lumbar curves, whereas cervicothoracic kyphosis occurred more in double thoracic curves. Conclusions Pathological sagittal patterns are often already present in curves 10°–20°, whereas those are rare in non-scoliotic adolescents. This suggests that sagittal ‘malalignment’ patterns are an integral part of the early pathogenesis of AIS.

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