scholarly journals Evaluating the Rotation Correction of the Main Thoracic Curve in Severe Adolescent Idiopathic Scoliosis: Bending and Traction vs. Fulcrum – A Preliminary Report

2017 ◽  
Vol 23 ◽  
pp. 4981-4988 ◽  
Author(s):  
Qing-Jie Kong ◽  
Xiao-Fei Sun ◽  
Yuan Wang ◽  
Jing-Chuan Sun ◽  
Zi-qiang Chen ◽  
...  
2016 ◽  
Vol 29 (8) ◽  
pp. E434-E441 ◽  
Author(s):  
Jingfeng Li ◽  
Kenneth M.C. Cheung ◽  
Dino Samartzis ◽  
Anne K.B. Ganal-Antonio ◽  
Xiaodong Zhu ◽  
...  

2012 ◽  
Vol 17 (3) ◽  
pp. 212-219 ◽  
Author(s):  
Steven W. Hwang ◽  
Amer F. Samdani ◽  
Ben Wormser ◽  
Hari Amin ◽  
Jeff S. Kimball ◽  
...  

Object Pedicle screw fixation has been theorized to provide better correction of scoliotic deformity, but controversy over the benefits of pedicle screw–only constructs remains, and the longer-term impact of pedicle screw fixation as compared with hybrid constructs is unclear. In this study, a retrospective review of a prospectively collected database was conducted to determine the longer-term impact of pedicle screw fixation as compared with hybrid constructs in patients with adolescent idiopathic scoliosis (AIS). Methods The authors retrospectively reviewed a multicenter database of pediatric patients (ages ≤ 18) from 1995 to 2006 and identified 127 patients with Lenke Type 1–4 AIS curves with a minimum 5 years of follow-up. Patients were divided into 2 cohorts based on whether they had undergone pedicle screw fixation or fixation with hybrid constructs. Results The mean main thoracic curvature of 56.1° ± 13.0°, which corrected to 14.9° ± 9.3°, translated into a mean correction of 73% (p < 0.01). The curve was 19.4° ± 10.6° at 2-year follow-up and 20.5° ± 10.4° at 5 years. When comparing preoperative parameters between the groups, differences were noted in the magnitude of the main thoracic curve (p = 0.04), flexibility of the main thoracic curve (p = 0.02), coronal balance (p = 0.04), T2–12 kyphosis (p = 0.02), and sex (p = 0.02). The pedicle screw cohort had fewer spinal segments instrumented (p < 0.01), fewer anterior releases performed (p = 0.02), and fewer thoracoplasties performed (p < 0.01). By 5 years of follow-up, significant differences were apparent between the two cohorts with respect to upper thoracic curvature (p = 0.01), T2–12 (p = 0.02) and T5–12 (p = 0.02) kyphosis, lumbar lordosis (p < 0.01), and sagittal balance (p = 0.01). Conclusions Although some preoperative differences did exist, outcomes were comparable between hybrid and screw constructs at 2 and 5 years. However, hybrid constructs required more concurrent anterior releases and thoracoplasties to achieve similar results.


2018 ◽  
Vol 23 (1) ◽  
pp. 14-19 ◽  
Author(s):  
Tetsuhiko Mimura ◽  
Jun Takahashi ◽  
Shota Ikegami ◽  
Shugo Kuraishi ◽  
Masayuki Shimizu ◽  
...  

Spine ◽  
2001 ◽  
Vol 26 (18) ◽  
pp. 1966-1975 ◽  
Author(s):  
Timothy R. Kuklo ◽  
Lawrence G. Lenke ◽  
Douglas S. Won ◽  
Eric J. Graham ◽  
Fred A. Sweet ◽  
...  

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 ◽  
...  

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).


2019 ◽  
Vol 24 (3) ◽  
pp. 415-419 ◽  
Author(s):  
Masashi Uehara ◽  
Jun Takahashi ◽  
Shota Ikegami ◽  
Hiroki Oba ◽  
Shugo Kuraishi ◽  
...  

Author(s):  
Yonggang Wang ◽  
Fengguang Yang ◽  
Dongmin Wang ◽  
Haiyan Zhao ◽  
Zhanjun Ma ◽  
...  

Abstract Background Scoliosis causes thoracic deformities, and it is necessary to assess these changes in pulmonary function test (PFT). To determine how measurements of spinal and thoracic cage deformities are related to pulmonary function. Methods Seventy-two patients with main right thoracic curvature in adolescent idiopathic scoliosis (AIS) underwent a PFT and a radiological parameter evaluation of spinal and thoracic cage deformities. Simple and multiple linear regressions were also used to note whether a combination of variables might better predict PFT values. Means were compared using the two-sample t test or one-way ANOVA with Tukey’s multiple comparison methods. Results Forced vital capacity (FVC)% predicted had significantly negative correlations with main thoracic curve Cobb (MT-Cobb) (R2 = 0.648, p < 0.001), main thoracic curve-rib hump (MT-RH) (R2 = 0.522, p < 0.001), main thoracic curve apical vertebral body-to-rib ratio (MT-AVB-R) (R2 = 0.536, p < 0.001), and main thoracic curve apical vertebra translation (MT-AVT) (R2 = 0.383, p < 0.001). Multiple regression analysis was performed with FVC% predicted as the dependent variable and MT-Cobb, MT-RH, MT-AVB-R, and MT-AVT as the independent variables. MT-Cobb, MT-RH, MT-AVB-R, and MT-AVT were factors with a significant effect on FVC% predicted (p < 0.001). For 45 patients who had preoperative FVC impairment (FVC% predicted < 80%), their MT-Cobb averaged 76.71°. Twenty-seven patients with normal preoperative FVC (FVC% predicted ≥ 80%) had a smaller mean MT-Cobb of 52.03° (p < 0.001). In other radiological parameters, the impaired FVC group had a MT-AVT of 54.29 mm compared to 38.06 mm for the normal FVC group (p < 0.001). MT-AVB-R averaged 2.92 for the impaired FVC group and 1.78 for the normal FVC group (p < 0.001). MT-RH averaged 28.79 mm for the impaired group and 16.62 mm for the normal group (p < 0.001). Further stratification of preoperative PFT results is divided into three groups. The three groups also showed significant differences in MT-Cobb, MT-RH, MT-AVB-R, and MT-AVT (p < 0.001). Conclusion Severe scoliosis leads to an increased degree of thoracic deformity, which increases the risk of lung damage in AIS. Moreover, a more accurate assessment of pulmonary function is achieved through radiological parameters and PFTs.


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