P83. Fractional curve correction using TLIF vs ALIF in adult scoliosis

2021 ◽  
Vol 21 (9) ◽  
pp. S180
Author(s):  
Thomas Buell ◽  
Christopher I. Shaffrey ◽  
Shay Bess ◽  
Han Jo Kim ◽  
Eric O. Klineberg ◽  
...  
Keyword(s):  
Adult Scoliosis ◽  
Curve Correction

scholarly journals Proximal Junction Kyphosis in Adult Scoliosis. Best Post-Operative Radiological Predictors. Retrospective Cohort Study

2020 ◽  
Author(s):  
Zhang Qi Hong ◽  
Daudi Romani Manini ◽  
Xiang YU Wang ◽  
Xuan YU Du
Keyword(s):  
Lumbar Lordosis ◽  
Thoracic Kyphosis ◽  
Pelvic Incidence ◽  
Sagittal Alignment ◽  
Deformity Correction ◽  
Adult Scoliosis ◽  
Curve Correction ◽  
Spine Shape ◽  
Global Sagittal Alignment ◽  
The Mean

Abstract Background: Proximal junction kyphosis (PJK) is the post-surgical radiographic event seen in the surgical plane after the fusion of spinal deformity. Unfavorable health outcomes have been reported in symptomatic PJK patients. The purpose of this study was to assess which immediate post-surgical radiographic variable from the four proposed formulae is the best in forecasting the future occurrences of PJK in adult scoliosis after undergoing deformity correction.Methods: Data for adult scoliosis patients who underwent curve correction were extracted from the hospital database. Pelvic and spinal parameters were measured and calculated to compare four predictive formulae for occurrences of PJK. Formula 1：Restoration of hypothetical values of lumbar lordosis (LL) and thoracic kyphosis (TK) according to pelvic incidence (PI). Formula 2: evaluation of global sagittal alignment (GSA). Formula 3: Restoration of the apex of LL to its hypothetical position according to the spine shape. Formula 4: evaluation of positive-sum and negative-sum of (LL + TK).Results: The total number of cases was 52. There were 14 cases of PJK, the incidence of PJK was 26.9% and the mean age for PJK cases was 63.2±5.2. The excellent predictor for occurrences of PJK was formula 3, postsurgical sagittal apexes of lumbar lordosis were located in their hypothetical position in 24 cases, and 12.5% of these cases developed PJK. While sagittal apexes were not located in hypothetical position in 28 patients, 39.3% of patients developed PJK. P =0.03, OR 4.53, (95% CI 1.09-18.9). The second good predictor for occurrences of PJK was formula 2. GSA > 450 versus GSA <450 OR= 2.5, (95% CI, 0.67-9.38), P= 0.17. The other two formulae (1 and 4) were not good predictors for occurrences of PJK.Conclusion: Among the proposed formulae for predicting occurrences of PJK, the position of the sagittal apex of lumbar lordosis is an excellent predictor of the development of PJK followed by GSA. Hypothetical values of LL and TK, positive or negative-sum of (LL+TK) are weak predictors for occurrences of PJK.Trial registration: “retrospective registered”

Adult scoliosis surgery outcomes: a systematic review

2010 ◽  
Vol 28 (3) ◽  
pp. E3 ◽  
Author(s):  
Sanjay Yadla ◽  
Mitchell G. Maltenfort ◽  
John K. Ratliff ◽  
James S. Harrop
Keyword(s):  
Systematic Review ◽  
Perioperative Complications ◽  
Adult Scoliosis ◽  
Spine Deformity ◽  
Scoliosis Surgery ◽  
Curve Correction ◽  
Major Curve ◽  
The Mean ◽  
Surgery Outcomes

Object Appreciation of the optimal management of skeletally mature patients with spinal deformities requires understanding of the natural history of the disease relative to expected outcomes of surgical intervention. Appropriate outcome measures are necessary to define the surgical treatment. Unfortunately, the literature lacks prospective randomized data. The majority of published series report outcomes of a particular surgical approach, procedure, or surgeon. The purpose of the current study was to systematically review the present spine deformity literature and assess the available data on clinical and radiographic outcome measurements. Methods A systematic review of MEDLINE and PubMed databases was performed to identify articles published from 1950 to the present using the following key words: “adult scoliosis surgery,” “adult spine deformity surgery,” “outcomes,” and “complications.” Exclusion criteria included follow-up shorter than 2 years and mean patient age younger than 18 years. Data on major curve (coronal scoliosis or lumbar lordosis Cobb angle as reported), major curve correction, Oswestry Disability Index (ODI) scores, Scoliosis Research Society (SRS) instrument scores, complications, and pseudarthroses were recorded. Results Forty-nine articles were obtained and included in this review; 3299 patient data points were analyzed. The mean age was 47.7 years, and the mean follow-up period was 3.6 years. The average major curve correction was 26.6° (for 2188 patients); for 2129 patients, it was possible to calculate average curve reduction as a percentage (40.7%). The mean total ODI was 41.2 (for 1289 patients), and the mean postoperative reduction in ODI was 15.7 (for 911 patients). The mean SRS-30 equivalent score was 97.1 (for 1700 patients) with a mean postoperative decrease of 23.1 (for 999 patients). There were 897 reported complications for 2175 patients (41.2%) and 319 pseudarthroses for 2469 patients (12.9%). Conclusions Surgery for adult scoliosis is associated with improvement in radiographic and clinical outcomes at a minimum 2-year follow-up. Perioperative morbidity includes an approximately 13% risk of pseudarthrosis and a greater than 40% incidence of perioperative adverse events. Incidence of perioperative complications is substantial and must be considered when deciding optimal disease management. Although the quality of published studies in this area has improved, particularly in the last few years, the current review highlights the lack of routine use of standardized outcomes measures and assessment in the adult scoliosis literature.

Interactive Image Quality Enhancement Support System by Tone Curve Correction Based on Human KANSEI

2009 ◽  
Vol 129 (6) ◽  
pp. 593-600 ◽  
Author(s):  
Yuichiro Tokuda ◽  
Gosuke Ohashi ◽  
Masato Tsukada ◽  
Reiichi Kobayashi ◽  
Yoshifumi Shimodaira
Keyword(s):  
Image Quality ◽  
Support System ◽  
Quality Enhancement ◽  
Curve Correction ◽  
Image Quality Enhancement

The impact of increasing interbody fusion levels at the fractional curve on lordosis, curve correction, and complications in adult patients with scoliosis

2020 ◽  
pp. 1-10
Author(s):  
Dominic Amara ◽  
Praveen V. Mummaneni ◽  
Shane Burch ◽  
Vedat Deviren ◽  
Christopher P. Ames ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Revision Surgery ◽  
Lumbar Lordosis ◽  
Interbody Fusion ◽  
Pelvic Incidence ◽  
Secondary Analysis ◽  
Lumbar Interbody Fusion ◽  
Curve Correction ◽  
Surgery Rates

OBJECTIVERadiculopathy from the fractional curve, usually from L3 to S1, can create severe disability. However, treatment methods of the curve vary. The authors evaluated the effect of adding more levels of interbody fusion during treatment of the fractional curve.METHODSA single-institution retrospective review of adult patients treated for scoliosis between 2006 and 2016 was performed. Inclusion criteria were as follows: fractional curves from L3 to S1 > 10°, ipsilateral radicular symptoms concordant on the fractional curve concavity side, patients who underwent at least 1 interbody fusion at the level of the fractional curve, and a minimum 1-year follow-up. Primary outcomes included changes in fractional curve correction, lumbar lordosis change, pelvic incidence − lumbar lordosis mismatch change, scoliosis major curve correction, and rates of revision surgery and postoperative complications. Secondary analysis compared the same outcomes among patients undergoing posterior, anterior, and lateral approaches for their interbody fusion.RESULTSA total of 78 patients were included. There were no significant differences in age, sex, BMI, prior surgery, fractional curve degree, pelvic tilt, pelvic incidence, pelvic incidence − lumbar lordosis mismatch, sagittal vertical axis, coronal balance, scoliotic curve magnitude, proportion of patients undergoing an osteotomy, or average number of levels fused among the groups. The mean follow-up was 35.8 months (range 12–150 months). Patients undergoing more levels of interbody fusion had more fractional curve correction (7.4° vs 12.3° vs 12.1° for 1, 2, and 3 levels; p = 0.009); greater increase in lumbar lordosis (−1.8° vs 6.2° vs 13.7°, p = 0.003); and more scoliosis major curve correction (13.0° vs 13.7° vs 24.4°, p = 0.01). There were no statistically significant differences among the groups with regard to postoperative complications (overall rate 47.4%, p = 0.85) or need for revision surgery (overall rate 30.7%, p = 0.25). In the secondary analysis, patients undergoing anterior lumbar interbody fusion (ALIF) had a greater increase in lumbar lordosis (9.1° vs −0.87° for ALIF vs transforaminal lumbar interbody fusion [TLIF], p = 0.028), but also higher revision surgery rates unrelated to adjacent-segment pathology (25% vs 4.3%, p = 0.046). Higher ALIF revision surgery rates were driven by rod fracture in the majority (55%) of cases.CONCLUSIONSMore levels of interbody fusion resulted in increased lordosis, scoliosis curve correction, and fractional curve correction. However, additional levels of interbody fusion up to 3 levels did not result in more postoperative complications or morbidity. ALIF resulted in a greater lumbar lordosis increase than TLIF, but ALIF had higher revision surgery rates.

Supine Traction Versus Prone Bending Radiographs for Assessing the Curve Flexibility in Spinal Deformity

2021 ◽  
pp. 219256822097913
Author(s):  
Niek te Hennepe ◽  
Maarten Spruit ◽  
Martin H. Pouw ◽  
Marco Hinderks ◽  
Petra Heesterbeek
Keyword(s):  
Idiopathic Scoliosis ◽  
Spinal Deformity ◽  
Retrospective Cohort ◽  
De Novo ◽  
Traction Force ◽  
Degenerative Lumbar Scoliosis ◽  
Curve Correction ◽  
Subgroup Analyses ◽  
The Difference ◽  
Side Bending

Study Design: Retrospective cohort study. Objectives: No consensus exists among surgeons on which radiologic method to prefer for the assessment of curve flexibility in spinal deformity. The objective of this study was to evaluate the difference in curve correction on supine traction radiographs versus prone side bending radiographs. Methods: A retrospective analysis of idiopathic scoliosis (IS), degenerative idiopathic scoliosis (DIS) and de novo degenerative lumbar scoliosis (DNDLS) patients was performed on supine traction as well as prone bending films (when available). Age, weight, traction force, diagnosis and Cobb angles of the primary and secondary curves were extracted. Differences in curve correction (percentages) on traction versus prone bending radiographs were analyzed for the primary and secondary curve. Subgroup analyses were performed for the 3 different diagnoses. Results: In total, 170 patients were eligible for inclusion. 43 were diagnosed with IS, 58 with DIS and 69 with DNDLS. For the primary curve, greater curve correction was obtained with bending in the DNDLS group ( P < 0.001). In the DIS group, there was a trend toward more correction on bending ( P = 0.054). In de IS group no difference was found. For the secondary curve, bending showed more curve correction in the IS and DIS group ( P = 0.002 and P <0.001). No difference was found in the DNDLS group. Conclusion: Compared to traction radiographs, bending radiographs better serve the purpose of curve flexibility assessment of IS, DIS and DNDLS spinal deformity, despite the fact that patients are exposed to more radiation.

scholarly journals The adult scoliosis

2005 ◽  
Vol 14 (10) ◽  
pp. 925-948 ◽  
Author(s):  
Max Aebi
Keyword(s):  
Adult Scoliosis

scholarly journals Adult scoliosis and non-specific low back pain: analysis of trunk kinematics

Scoliosis ◽  
2013 ◽  
Vol 8 (S1) ◽  
Author(s):  
L Bissolotti ◽  
V Sani ◽  
M Gobbo ◽  
C Orizio
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Adult Scoliosis ◽  
Low Back ◽  
Trunk Kinematics ◽  
Pain Analysis

CLASSIFICATION SYSTEMS FOR ADOLESCENT AND ADULT SCOLIOSIS

Neurosurgery ◽  
2008 ◽  
Vol 63 (suppl_3) ◽  
pp. A16-A24 ◽  
Author(s):  
Justin S. Smith ◽  
Christopher I. Shaffrey ◽  
Charles Kuntz ◽  
Praveen V. Mummaneni
Keyword(s):  
Health Care Providers ◽  
Research Society ◽  
Classification Systems ◽  
Adult Scoliosis ◽  
Care Providers ◽  
Classification Schemes ◽  
Scoliosis Research Society ◽  
Adult Degenerative Scoliosis ◽  
Spinal Abnormality

ABSTRACT OBJECTIVE To review current classification systems for adolescent and adult scoliosis. METHODS The literature was reviewed in reference to scoliosis classification systems for adolescent and adult scoliosis. RESULTS There are multiple classification systems for scoliosis. Classification of scoliosis is dependent on patient age, spinal abnormality, scoliotic curve, and global spinal alignment. To date, classification systems have focused predominantly on adolescent idiopathic scoliosis or adult/degenerative scoliosis; a single classification system evaluating scoliotic deformities of different ages and spinal abnormalities has not been identified. CONCLUSION The importance of scoliosis classification schemes lies in their ability to standardize communication among health care providers. With regard to the classification of adolescent scoliosis, the Lenke system has addressed many of the significant limitations of the King system and is now the standard classification scheme. Classification schemes for adult scoliosis have been reported only recently, and each offers specific advantages (the simple pathogenesis-based system of Aebi, the strong clinical relevance of the Schwab system, and the richly descriptive Scoliosis Research Society system). This article highlights the salient features of currently used scoliosis classification systems.

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