scholarly journals Radiological outcomes of the selective spinal fusion for lenke type 5C adolescent idiopathic scoliosis

2021 ◽  
Vol 13 (1) ◽  
pp. 6-9
Author(s):  
Ghanshyam Kakadiya ◽  
Kalpesh Saindane ◽  
Viraj Gandbhir ◽  
Yogesh Soni, ◽  
Kushal Gohil ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Cobb Angle ◽  
Spinal Instrumentation ◽  
Pedicle Screws ◽  
P Value ◽  
Coronal Balance ◽  
Angle Correction ◽  
The Mean ◽  
Implant Density

Objective: To determine the short term radiological outcomes of Lenke type 5C adolescent idiopathic scoliosis in terms of Cobb angle correction and coronal balance after selective posterior segmental spinal instrumentation with pedicle screws. Methods: This retrospective cohort study was conducted in the department of Orthopaedic at tertiary care public hospital of Mumbai, India. The medical records of patients from 17th April 2015 to 29th October 2019 who underwent a selective spinal fusion with pedicle screws for Lenke type-5C adolescent idiopathic scoliosis were reviewed. Preoperative radiographs were evaluated for Cobb angle of the lumbar or thoracolumbar curve as well as a sagittal and lumbar modifier on anteroposterior and lateral standing films. The curve correction, implant density, number of segment fused and coronal balance was assessed on postoperative radiographs. The pre and postoperative comparison of important study variables was done and P-value was calculated with the help of the chi-square test. P-value <0.05 was considered statistically significant. Results: The total number of patients was 34. Majority (94.1%, n=32) were females while only 2(5.9%) were males. The mean age at the time of operation was 14.35±2.19 years (range 8 to 19 years). Mean pre-operative and post-operative Cobb angles were 61.790±13.120 (range 400 to 850) and 10.550±8.710 (range 00 to 300) respectively (P-value 0.00). The mean percentage of curve correction and percentage of fulcrum flexibility was 83.35±13.07 % (range 55% to 100%) and 59.56%±15.07 (range 28.57% to 84.60%) respectively (P value 0.469). Mean implant density and fusion mass was 66.03±7.94% (range 53 to 79%) and 10.32±2.8 (range 7 to 15%) segments respectively. The coronal balance was achieved in all patients. No major complication was noted. Conclusion: Near normal Cobb angle correction and coronal balance was achieved in all patients of Lenke type 5C adolescent idiopathic scoliosis treated with posterior segmental spinal instrumentation utilizing pedicle screws.

Correction of adolescent idiopathic scoliosis using a convex pedicle screw technique with low implant density

2021 ◽  
Vol 103-B (3) ◽  
pp. 536-541
Author(s):  
Peter W. Ferlic ◽  
Laurenz Hauser ◽  
Michael Götzen ◽  
Richard Andreas Lindtner ◽  
Stefan Fischler ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Cobb Angle ◽  
Pedicle Screw ◽  
Operating Time ◽  
Pedicle Screws ◽  
Patient Reported ◽  
Group 2 ◽  
Implant Density ◽  
Group 1

Aims The aim of this retrospective study was to compare the correction achieved using a convex pedicle screw technique and a low implant density achieved using periapical concave-sided screws and a high implant density. We hypothesized that there would be no difference in outcome between the two techniques. Methods We retrospectively analyzed a series of 51 patients with a thoracic adolescent idiopathic scoliosis. There were 26 patients in the convex pedicle screw group who had screws implanted periapically (Group 2) and a control group of 25 patients with bilateral pedicle screws (Group 1). The patients’ charts were reviewed and pre- and postoperative radiographs evaluated. Postoperative patient-reported outcome measures (PROMs) were recorded. Results The number of implants (14.5 vs 17.1) and the implant density (1.5 vs 1.9) were significantly lower in Group 2 (p < 0.001). Operating time was 27 minutes shorter in Group 2 than in Group 1, with a mean of 217 minutes (SD 50.5; 120 to 346). The duration of surgery per instrumented vertebra was reduced by 19% in Group 2 (p = 0.011). No statistical difference was found in the postoperative Cobb angle, vertebral rotation, the relative correction achieved, or postoperative PROMs. Conclusion Despite a lower implant density and achieving correction through a convex rod, surgical correction of the Cobb angle and vertebral body rotation was similar in both groups. Periapical pedicle screws and primary correction on the concave side do not seem to be mandatory in order to achieve good surgical results in idiopathic thoracic scoliosis. The operating time was shorter in the group with lower implant density. In conclusion, the technique provided good results and has the potential to reduce complications and costs. Cite this article: Bone Joint J 2021;103-B(3):536–541.

The effect of Cobb angle correction on spinal length gain in patients with adolescent idiopathic scoliosis

2019 ◽  
Vol 28 (1) ◽  
pp. 22-26
Author(s):  
Hassan Ghandhari ◽  
Ebrahim Ameri ◽  
Mir Bahram Safari ◽  
Habib Kheirabadi ◽  
Hadi S. Asl ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Cobb Angle ◽  
Angle Correction ◽  
Length Gain

scholarly journals Comparative analysis of pedicle screw versus hybrid instrumentation in adolescent idiopathic scoliosis surgery

2016 ◽  
Vol 7 (04) ◽  
pp. 550-553 ◽  
Author(s):  
Sohail Rafi ◽  
Naseem Munshi ◽  
Asad Abbas ◽  
Rabia Hassan Shaikh ◽  
Imtiaz Hashmi
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Cobb Angle ◽  
Pedicle Screw ◽  
Pedicle Screws ◽  
Scoliosis Surgery ◽  
Hybrid Instrumentation ◽  
System Versus ◽  
Cobb’S Angle

ABSTRACT Introduction: Adolescent idiopathic scoliosis is the most common type of scoliosis. A Cobb angle of 50° will progress beyond the age of spinal maturity. Surgery over bracing is advised at a Cobb angle above or equal to 50°. The aim of surgery is to bring the Cobb angle down below 50° to prevent reprogression as well as improve the quality of life. The objective of the study is to analyze the efficacy and significance in lifestyle improvement of pedicle screw-only fixation system versus the more common hybrid instrumentation system used for the surgical treatment of adolescent idiopathic scoliosis. Materials and Methods: A prospective cohort study was conducted involving two groups of patients were included in the study. One group was operated with pedicle screw-only method while the other with hybrid instrumentation system. The pre- and post-operative Cobb’s angles were taken across a follow-up of 4 years. An SRS-30 questionnaire was given in a yearly follow-up to assess the lifestyle improvement of the patient. Results: Pedicle screw-only method was significantly more effective in reducing Cobb’s angle (P = 0.0487). It was showed less loss of correction (P = 0.009) pedicle screw-only surgery was also better at reducing thoracic curves (P = 0.001). There seemed a better recovery time with pedicle screw surgery (P = 0.003). Conclusion: Pedicle screws are more effective and durable than hybrid systems at when treating adolescent idiopathic scoliosis.

scholarly journals IN-BRACE CORRECTION (IBC) TERHADAP TIPE DAN BESARAN KURVA PADA PASIEN ADOLESCENT IDIOPATHIC SKOLIOSIS (AIS)

2020 ◽  
Vol 14 (1) ◽  
pp. 46-52
Author(s):  
Raden Candra ◽  
Fika Trifani
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Cobb Angle ◽  
P Value ◽  
X Ray

Skoliosis adalah kelengkungan tulang belakang ke lateral yang melebihi 10 derajat. Tinjauan lapangan pada klinik dan rumah sakit di Indonesia menunjukan banyaknya kasus pasien Adolescent Idiopathic Scoliosis (AIS) yang telah ditangani dengan penggunaan skoliosis brace. In-brace correction (IBR) merupakan cara menilai kualitas skoliosis brace secara cepat setelah brace dipasangkan kepada pasien dengan metode X-Ray dengan menggunakan brace. Akan tetapi, hasil IBR tersebut sering ditemukan berbeda dari satu pasien dengan yang lainnya sehingga dibutuhkan untuk mengetahui faktor yang dapat menyebabkan perbedaan tersebut. Oleh karena itu, tujuan pada penelitian ini adalah untuk menilai apakah terdapat hubungan antara tipe kurva dan besaran kurva terhadap IBR pada pasien AIS. Analisis retrospective sebanyak 120 data sekunder telah digunakan dalam penelitian ini melalui rekam medis pasien yang menggunakan scoliosis brace dari tahun 2016 - 2018. Data yang diambil berupa Cobb angle tanpa menggunakan brace, In-Brace Cobb angle, dan tipe kurva skoliosis. Rata-rata IBR adalah 56,0% pada besaran kurva ringan (20°-29°), 37,2% pada besaran kurva sedang (30° - 40°), 36,7% pada besaran kurva parah (>40°). Sedangkan, rata-rata IBR tertinggi adalah pada tipe kurva ganda dimana lumbar > thoraks yaitu sebesar 50,3%, lalu disusul dengan kurva tunggal thoraks dan kurva ganda thoraks > lumbar sebesar 40,3% dan 39,1% secara berurutan. terdapat perbedaan yang signifikan IBR bedasarkan Besaran Kurva dan Tipe Kurva pada pasien adolescent idiopatik skoliosis dengan p value 0,000 dan 0,029 secara berurutan. Dapat disimpulkan bahwa tipe dan besaran kurva scoliosis merupakan faktor yang dapat mempengaruhi hasil IBR secara signifikan

scholarly journals Iphone app use to Cobb angle in adolescent idiopathic scoliosis: Does this apply?

2015 ◽  
Vol 14 (2) ◽  
pp. 101-104 ◽  
Author(s):  
Antenor Rafael de Oliveira Mazzuia ◽  
Diógenes Rodrigues Machado ◽  
Denis Kiyoshi Fukumothi ◽  
Luccas Franco Bettencourt Nunes ◽  
Carlos Tucci Neto ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Standard Deviation ◽  
Adolescent Idiopathic Scoliosis ◽  
Confidence Interval ◽  
Idiopathic Scoliosis ◽  
Cobb Angle ◽  
Traditional Method ◽  
Mobile App ◽  
Radiographic Measurements ◽  
The Mean

<sec><title>OBJECTIVE:</title><p> To validate a new method of measuring the Cobb angle for scoliosis from the mobile app CobbMeter to facilitate the evaluation and measurement in clinical practice.</p></sec><sec><title>METHODS:</title><p> Five observers with minimum experience of two years in the field performed radiographic measurements of Cobb angle in 24 radiographs of patients with adolescent idiopathic scoliosis through the CobbMeter. Observers performed serial measures on the images with the application, which were repeated after one month. The most experienced appraiser of the group, after measurements were made through the application, determined the Cobb angle in each radiography by the traditional method.</p></sec><sec><title>RESULTS:</title><p> The mean standard deviation by comparing the angles electronically and manually measured had no clinical significance. Although 40% of electronic measurements are outside the confidence interval when compared to manual measurements, this difference was insignificant in clinical practice.</p></sec><sec><title>CONCLUSIONS:</title><p> The CobbMeter is another alternative for measuring Cobb angle in scoliosis.</p></sec>

scholarly journals Alternate In-Brace and Out-of-Brace Radiographs Are Recommended to Assess Brace Fitting and Curve Progression With Adolescent Idiopathic Scoliosis Follow-Up

2021 ◽  
pp. 219256822110325
Author(s):  
Sachiko Kawasaki ◽  
Prudence Wing Hang Cheung ◽  
Hideki Shigematsu ◽  
Masato Tanaka ◽  
Yuma Suga ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Cobb Angle ◽  
Curve Progression ◽  
Brace Treatment ◽  
Correction Rate ◽  
Angle Correction ◽  
Clinically Significant ◽  
Deterioration Group

Study Design: Retrospective cohort study. Objective: To determine the prevalence of missed curve progression in patients with adolescent idiopathic scoliosis (AIS) undergoing brace treatment with only in-brace follow-up radiographs, and to provide recommendations on when in-brace and out-of-brace should be obtained during follow-up. Methods: 133 patients who had documented clinically significant curve progression during brace treatment or only when an out-of-brace radiograph were studied. Of these, 95 patients (71.4%) had curve progression noted on in-brace radiographs while 38 patients (28.6%) showed curve progression only after brace removal. We analyzed differences in age, sex, curve types, Risser stage, months after menarche, standing out-of-brace Cobb angle, correction rate, and flexibility rate between the groups. Multivariate logistic regression was performed to determine factors contributing to curve progression missed during brace treatment. Results: There were no differences in initial Cobb angle between out-of-brace and in-brace deterioration groups. However, the correction rate was higher (32.7% vs 25.0%; P = .004) in the in-brace deterioration group as compared to the out-of-brace deterioration group. A lower correction rate was more likely to result in out-of-brace deterioration (OR 0.970; P = .019). For thoracic curves, higher flexibility in the curves was more likely to result in out-of-brace deterioration (OR 1.055; P = .045). For double/triple curves, patients with in-brace deterioration had higher correction rate (OR 0.944; P = .034). Conclusions: Patients may develop curve progression despite good correction on in-brace radiographs. Those with higher flexibility and suboptimal brace fitting are at-risk. In-brace and out-of-brace radiographs should be taken alternately for brace treatment follow-up.

Effect of adjunct thoracoplasty on Adolescent Idiopathic Scoliosis patients’ 3D back contour

2021 ◽  
Author(s):  
J Horng ◽  
XC Liu ◽  
J Thometz ◽  
C Tassone
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Surface Topography ◽  
Spinal Fusion ◽  
Spinal Instrumentation ◽  
Pedicle Screws ◽  
Posterior Spinal Fusion ◽  
Clinically Significant ◽  
Unit Reduction ◽  
Trunk Asymmetry

The aims of this study were to evaluate the effect of a thoracoplasty procedure in addition to a posterior spinal fusion and instrumentation on an Adolescent Idiopathic Scoliosis (AIS) patient’s 3D back contour as measured by surface topography. We performed a retrospective review to identify patients who were treated with posterior spinal fusion with spinal instrumentation and those who were treated with an additional thoracoplasty procedure. We analyzed changes in surface topography measurements between these two groups using t-test and ANCOVA statistical analyses. Although there were no statistically significant differences in 11 of 12 variables, thoracoplasty-posterior spinal fusion (n=10) group had a mean 6.6 unit reduction in trunk asymmetry while the posterior spinal fusion group (n=26) had a mean 22.8 unit reduction in trunk asymmetry (p-value<0.05). The posterior spinal fusion group and thoracoplasty-posterior spinal fusion group were not shown to have clinically significant differences in 3D back contour correction. An additional thoracoplasty procedure does not provide better correction in the transverse plane and in fact had a smaller degree of trunk asymmetry correction. This supports the current trends of decreasing use of thoracoplasty in AIS patients to address severe rib hump deformities given concerns for decreased post-operative lung function and alternative methods of vertebral body derotation, such as thoracic pedicle screws.

Assessment of the plane of maximum curvature for patients with adolescent idiopathic scoliosis via computed tomography

2020 ◽  
Vol 44 (5) ◽  
pp. 298-304
Author(s):  
Hui-Dong Wu ◽  
Winnie Chiu-Wing Chu ◽  
Cheng-Qi He ◽  
Man-Sang Wong
Keyword(s):  
Computed Tomography ◽  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Cobb Angle ◽  
Correlation Coefficient ◽  
Intraclass Correlation ◽  
Intrarater Reliability ◽  
Maximum Curvature ◽  
Curvature Measurements ◽  
The Mean

Background: In the assessment of three-dimensional features of adolescent idiopathic scoliosis, the plane of maximum curvature was compared with the coronal Cobb angle. Objectives: To investigate the intrarater reliability, variability, and difference of the prone plane of maximum curvature measurements taken from computed tomography using the constrained and unconstrained Cobb methods; to assess the difference and correlation between the prone plane of maximum curvature measurements obtained using the constrained and unconstrained Cobb methods; and to examine differences and correlation between the prone plane of maximum curvature Cobb angle and coronal Cobb angle measurements. Study design: Retrospective study. Methods: Records of 29 subjects with adolescent idiopathic scoliosis aged 15.8 ± 3.5 years were reviewed (25 thoracic and 24 thoracolumbar/lumbar curves). An experienced rater measured the plane of maximum curvature using the constrained and unconstrained Cobb methods, and the coronal Cobb angles using the conventional Cobb method on computed tomography images 3 times each with 1-week interval. The intraclass correlation coefficient (2,1), Pearson correlation coefficient ( r), one-way repeated measures analysis of variance, and paired t test were applied for various analyses. Results: The intraclass correlation coefficients for all intrarater reliability assessments were greater than 0.87. The plane of maximum curvature measurements of the two Cobb methods were excellently correlated ( r ⩾ 0.97) with no significant difference ( P > 0.05). The mean plane of maximum curvature Cobb angle was moderately correlated with ( r > 0.72) but significantly greater ( P < 0.001) than the mean coronal Cobb angle. Conclusion: The plane of maximum curvature measurements obtained from computed tomography were found to be reliable while the plane of maximum curvature measurements of the two Cobb methods were comparable. The mean plane of maximum curvature Cobb angle was moderately correlated with but significantly greater than the mean coronal Cobb angle. Clinical relevance The plane of maximum curvature measurements taken from computed tomography was found to be reliable, hence it could be used as a supplement to the coronal Cobb angle in the assessment and management of adolescent idiopathic scoliosis. With technological advancement, the radiation dose of computed tomography can be further reduced to a safer level for a broader range of cases.

scholarly journals Long-Term Surgical Results of Skip Pedicle Screw Fixation for Patients with Adolescent Idiopathic Scoliosis: A Minimum-Ten-Year Follow-Up Study

2020 ◽  
Vol 9 (12) ◽  
pp. 4002
Author(s):  
Masashi Uehara ◽  
Shugo Kuraishi ◽  
Shota Ikegami ◽  
Hiroki Oba ◽  
Takashi Takizawa ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Cobb Angle ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Patient Questionnaire ◽  
The Mean

Skip pedicle screw fixation for adolescent idiopathic scoliosis (AIS) requires fewer screws and can reduce the risk of neurovascular injury as compared with segmental pedicle screw fixation. However, the long-term impact of screw number reduction on correction and clinical results is unclear. This study examined the 10-year post-operative outcomes of skip pedicle screw fixation for patients with AIS. We reviewed the outcomes of 30 patients who underwent skip pedicle screw fixation for AIS. Radiological and clinical findings were assessed before and immediately, 2 years, and 10 years after surgery in the remaining 25 patients. The mean Cobb angle of the main curve preoperatively and immediately, 2 years, and 10 years post-operatively was 59.4°, 23.4°, 25.8°, and 25.60°, respectively, and was significantly improved at all post-surgical time points (all p < 0.001). The mean correction rate immediately after surgery was 60.8%, and the correction loss rate at the observation end point was 4.8%. The Cobb angle of the lumbar curve was significantly improved immediately after surgery, and the correction persisted until 10 years post-operatively. Remarkable gains were observed for most Scoliosis Research Society-22 patient questionnaire sub-scores at the final follow-up versus preoperative assessments. In conclusion, good correction of the AIS deformity by skip pedicle screw fixation was well maintained over a long follow-up period of 10 years, with clinically meaningful gains in Society-22 patient questionnaire sub-scores.

scholarly journals Effect of Cobb angle and BMI on scoliosis surgery recovery in adolescent idiopathic scoliosis patients

2015 ◽  
Vol 7 (2) ◽  
pp. 28-33
Author(s):  
Abdulmonem Alsiddiky ◽  
Abdullatef Alrashoudi ◽  
Ahmed AL Sayed ◽  
Albaraa Aljerian ◽  
Abeer Aljomiah
Keyword(s):  
Body Mass Index ◽  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Cobb Angle ◽  
Body Mass ◽  
Daily Living ◽  
Scoliosis Surgery ◽  
Mean Values ◽  
Cobb’S Angle ◽  
The Mean

Aims and Objectives: To assess the effect of Cobb angle and body mass index (BMI) on surgery recovery outcomes in Adolescent Idiopathic Scoliosis (AIS) patients.Materials and Methods: A retrospective study of 79 Adolescent Idiopathic Scoliosis patients who underwent corrective operations, at King Khaled University Hospital, Riyadh, Saudi Arabia was carried out in 2014. The patients were divided according into Cobb’s angle (mild, moderate and severe) and as per weight (healthy weight and overweight). Data of preoperative, intra-operative and postoperative information as well as measures of daily-living activities were collected.Results: The mean age of 79 patients (70females) was 16.6 years. Cobb angle assessment was mild in 41 (51.9%), moderate in 24(30.4%) and 14(17.7%) were severe. Mean surgery and recovery time of patients is statistically significantly different in relation to severity of Cobb’s angle (mild, moderate and severe). There is highly statistically significant difference in mean ranks of days taken for different measures of daily living in relation to severity of Cobb’s angle. The mean values of body mass index have significantly reduced after surgery, when compared with mean values at before surgery. The mean surgery time was statistically significantly higher in over weight patients (5.33 hours).Conclusions: The results show an effect of severity of Cobb angle on recovery measures of patients with AIS, but no effect of BMI. BMI was corrected in these patients after surgery. Prospective studies are required to assess clinical outcomes of post-operative surgery, satisfaction of patients towards their body image and quality of life.Asian Journal of Medical Sciences Vol.7(2) 2015 28-33

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