Can We Predict the Ultimate Lumbar Curve in Adolescent Idiopathic Scoliosis Patients Undergoing a Selective Fusion with Undercorrection of the Thoracic Curve?

Spine ◽  
2004 ◽  
Vol 29 (3) ◽  
pp. 277-285 ◽  
Author(s):  
Matthew B. Dobbs ◽  
Lawrence G. Lenke ◽  
Tim Walton ◽  
Michael Peelle ◽  
Greg Della Rocca ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Thoracic Curve ◽  
Lumbar Curve ◽  
Selective Fusion

Lenke 5C Curves in Adolescent Idiopathic Scoliosis: Anterior vs Posterior Selective Fusion

Neurosurgery ◽  
2015 ◽  
Vol 78 (3) ◽  
pp. 324-331 ◽  
Author(s):  
Yulei Dong ◽  
Xisheng Weng ◽  
Hong Zhao ◽  
Jianguo Zhang ◽  
Jianxiong Shen ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Case Series ◽  
Thoracic Curve ◽  
Selective Fusion ◽  
Posterior Group ◽  
Spontaneous Correction ◽  
Surgical Data ◽  
Large Case Series

Abstract BACKGROUND: The optimal treatment of Lenke 5C curves in adolescent idiopathic scoliosis is still unclear. OBJECTIVE: To compare the outcomes and the spontaneous correction behavior between anterior and posterior selective fusion techniques in a large case series. METHODS: Demographic and surgical data for patients with Lenke 5C curves treated with anterior or posterior fusion were collected from July 2002 to September 2011. Clinical assessment and radiographic parameters were compared preoperatively and postoperatively and at a minimum of 2 years of follow-up. RESULTS: Fifty-three Lenke 5C adolescent idiopathic scoliosis cases with an average follow-up of 4 years (range, 2-9.6 years) were included. The clinical scores were similar between the 2 groups. Postoperative major thoracic curvature changes were similar. The minor thoracic curve demonstrated a higher spontaneous correction rate in the posterior group. At follow-up, the minor thoracic curve showed a greater loss of correction in the posterior group, and finally both groups were comparable. Surgical time, intraoperative blood loss, and complications were comparable. A total of 5 patients had a final thoracic curve larger than the preoperative degrees. CONCLUSION: Selective fusion of the major thoracolumbar/lumbar curve in Lenke 5C adolescent idiopathic scoliosis can be achieved by anterior and posterior techniques. The spontaneous correction of the unfused thoracic curve was comparable after an average of 4 years follow-up.

Clinical outcomes of selective fusion for the thoracolumbar-lumbar curve in patients with Lenke type 6C adolescent idiopathic scoliosis

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Sam Yeol Chang ◽  
Jongyeon Son ◽  
Guang Bin Zheng ◽  
Bong-Soon Chang ◽  
Choon-Ki Lee ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Clinical Outcomes ◽  
Lumbar Curve ◽  
Selective Fusion

scholarly journals RADIOGRAPHICAL ANALYSIS OF FLEXIBILITY OF IDIOPATIC SCOLIOSIS IN PRONO AND SUPINO

2020 ◽  
Vol 19 (1) ◽  
pp. 13-17
Author(s):  
MARCELO PAULO MELO DE SOUZA ◽  
ANDRÉ FLAVIO FREIRE PEREIRA ◽  
TULIO ALBUQUERQUE DE MOURA RANGEL ◽  
RODRIGO CASTRO DE MEDEIROS ◽  
LUCIANO TEMPORAL BORGES CABRAL ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Supine Position ◽  
Thoracic Curve ◽  
Reference Standard ◽  
Lumbar Curve ◽  
Level Of Evidence ◽  
Main Thoracic ◽  
Significant Difference ◽  
The Mean

ABSTRACT Objective To determine if there is a statistically significant difference in the flexibility of the curves in the adolescent idiopathic scoliosis (AIS) by using lateral inclination radiographs in supine or prone decubitus. Methods We evaluated 19 patients with AIS, waiting for surgery. Radiographs of the patients were performed in orthostatic anteroposterior incidences and right and left lateral inclinations in prone and supine decubitus. The comparison between prone and supine decubitus was performed through the flexibility rates of the curves measured in each position. Results The mean flexibility rates measured in lateral inclination radiographs with the patient in the supine position were 54.4% ± 38.8% in the proximal thoracic curve, 45.8% ± 15.6% in the main thoracic curve, and 80.5% ± 20.7% in the thoracolumbar / lumbar curve. When the lateral inclination radiographs were performed with the patient in the prone position, we observed mean flexibility rates of 66.4% ± 34.3% in the proximal thoracic curve, 50.1% ± 12.8% in the main thoracic curve, and 80.6% ± 19.0% in the thoracolumbar / lumbar curve. Conclusion This present study did not find a statistically significant difference between the flexibility rates of the curves in the prone and supine positions, suggesting that the two radiographic methods analyzed are similar in the evaluation of the flexibility of the curves in adolescent idiopathic scoliosis. Level of evidence II; Development of diagnostic criteria in consecutive patients (with “gold” reference standard applied).

scholarly journals BESAR KURVA THORAKAL DAN LUMBAL MODIFIER SEBAGAI FAKTOR PREDIKSI TERHADAP KOREKSI SPONTAN KURVA LUMBAL PASKA OPERASI PADA ADOLESCENT IDIOPATHIC SCOLIOSIS LENKE I

Biomedika ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 74-80
Author(s):  
Anggita Tri Yurisworo ◽  
Bagas Widhiarso ◽  
Andhi Prijosedjati ◽  
Pamudji Utomo
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Posterior Instrumentation ◽  
Thoracic Curve ◽  
Dominant Factor ◽  
X Rays ◽  
Lumbar Curve ◽  
Curve Correction ◽  
Main Thoracic ◽  
Before And After

Adolescent idiopathic scoliosis Lenke I dengan pola kurva mayor pada kurva thorakal (main thoracic), dengan kurva proximal thoracic dan thoracolumbar/lumbar sebagai kurva minor non struktural. Instrumentasi dan fusi hanya pada kurva thorakal dianjurkan. Pada literatur dijelaskan bahwa koreksi spontan kurva lumbal terjadi sebagai kompensasi untuk menyeimbangkan kurva thorakal setelah dilakukannya fusi thorakal selektif. Lumbal modifier dibagi menjadi 3 grup, pemilihan terapi operatif bergantung pada tipe lumbal modifier. Penelitian ini merupakan suatu analisis observational pada 35 pasien adolescent idiopathic scoliosis Lenke I paska operasi koreksi deformitas dan instrumentasi posterior. evaluasi menggunakan X ray sebelum dan setelah operasi untuk penentuan tipe lumbal modifier, besarnya koreksi kurva thorakal dan penilaian koreksi spontan kurva lumbal, kemudian dilakukan uji korelasi terhadap data yang didapat. Besarnya koreksi kurva thorakal terhadap koreksi spontan kurva lumbal paska operasi memiliki nilai signifikansi (Sig) = 0,000 < 0,05 dan besarnya koreksi kurva thorakal memiliki nilai koefisien regresi lebih besar bila dibandingkan dengan lumbal modifier terhadap koreksi spontan kurva lumbal paska operasi (variabel besar koreksi kurva thorakal (X1) = 0,764, Lumbal modifier (X2) = 0,092). Besarnya koreksi kurva thorakal berpengaruh signifikan terhadap koreksi spontan kurva lumbal paska operasi dan besarnya koreksi kurva thorakal yang paling dominan dalam mempengaruhi koreksi spontan kurva lumbal dibandingkan dengan lumbal modifier.Kata kunci : Adolescent idiopathic scoliosis, Lumbal modifier, kurva thorakal Adolescent idiopathic scoliosis Lenke I, main thoracic curve pattern has the major curve, with the proximal thoracic and thoracolumbar/lumbar being non structural minor curves. Thus, instrumentation and fusion of the main thoracic region alone is recommended. In the literature it is said that the lumbar curve spontaneously corrects to balance the thoracic curve after selective thoracic fusion. Most authors assumed a mechanism whereby improvement of the lumbar curve occurred through counterbalancing the surgical correction of the thoracic curve. The lumbar curve divided in three subgroups: lumbar modifier A, B and C. The selection of specific operative treatments depends on this modifier. This study was an observational analysis in 35 adolescent idiopathic scoliosis Lenke I patients after correction and posterior instrumentation surgery. Evaluation using X-rays before and after surgery to determine the type of lumbar modifier, the magnitude of the main thoracic curve and assessment of spontaneous lumbar curve correction, then correlation test obtained. The magnitude of main thoracic curve correction to the spontaneous lumbar curve correction has a significance value (Sig) = 0.000 < 0.05 and the magnitude of main thoracic curve correction has a greater regression coefficient than the lumbar modifier for spontaneous lumbar curve correction (large correction variable thoracic curve (X1) = 0.764, Lumbal modifier (X2) = 0.092). The magnitude of main thoracic curve correction has a significant effect on the spontaneous lumbar curve correction and the magnitude of main thoracic curve correction is most dominant factor to influence spontaneous lumbar curve correction compared to the lumbar modifier.Keywords: Adolescent idiopathic scoliosis, Lumbar modifier, main thoracic

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.

scholarly journals The recognition and modelling of a backbone and its deformity

2014 ◽  
Vol 19 (1) ◽  
pp. 55-66
Author(s):  
Ramūnas Markauskas ◽  
Algimantas Juozapavičius ◽  
Kęstutis Saniukas ◽  
Giedrius Bernotavičius
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Input Data ◽  
Thoracic Curve ◽  
Line Centre ◽  
High Quality ◽  
Radiographic Images ◽  
Initial Curvature ◽  
Curvature Detection ◽  
Quality Features

In this article the authors present a method for the backbone recognition and modelling. The process of recognition combines some classical techniques (Hough transformation, GVF snakes) with some new (authors present a method for initial curvature detection, which they call the Falling Ball method). The result enables us to identify high-quality features of the spine and to detect the major deformities of backbone: the intercrestal line, centre sacral vertical line, C7 plumbline; as well as angles: proximal thoracic curve, main thoracic curve, thoracolumbar/lumbar. These features are used for measure in adolescent idiopathic scoliosis, especially in the case of treatment. Input data are just radiographic images, meet in everyday practice.

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