Comparison of four correction techniques for posterior spinal fusion in adolescent idiopathic scoliosis.
Adolescent idiopathic surgery
Reduction technique
Surgery
Thoracic kyphosis
Journal
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
ISSN: 1432-0932
Titre abrégé: Eur Spine J
Pays: Germany
ID NLM: 9301980
Informations de publication
Date de publication:
04 2022
04 2022
Historique:
received:
27
07
2021
accepted:
07
02
2022
revised:
21
01
2022
pubmed:
1
3
2022
medline:
12
4
2022
entrez:
28
2
2022
Statut:
ppublish
Résumé
When performing posterior spinal fusion for adolescent idiopathic scoliosis (AIS), it is of major importance to address both coronal and sagittal deformities. Although several techniques have been described, few data exist comparing them. Our objective was to compare four techniques (in situ bending (ISB), rod derotation (RD), cantilever (C) and posteromedial translation (PMT)) for the correction of spinal deformity in AIS including thoracic deformity. We conducted a multicenter retrospective study including 562 AIS patients with thoracic deformity with at least 24-month follow-up. Radiographic analysis was performed preoperatively, postoperatively and at last follow-up. The main outcomes were main curve correction and thoracic kyphosis restoration (TK). Coronal correction rate was significantly different among the four treatment groups (ISB 64% vs C 57% vs RD 55% vs PMT 67%, p < 0.001). Multivariate regression revealed that correction technique did not influence correction rate, whereas implant density, convex side compression and use of derotation connectors did. TK increase was significantly higher in the PMT group (average + 13°) than in DR (+ 3°), while ISB (-3°) and cantilever (-13°) resulted in TK decrease (p < 0.001). Multivariate analysis revealed that TK increase was only influenced by the reduction technique (p < 0.001) and preoperative TK (p < 0.001). The four techniques had the same ability to correct spinal deformity in the coronal plane. Three factors were identified to improve correction rate: implant density, convex compression and use of derotation connectors. On the other hand, PMT was more effective in restoring TK, particularly in hypokyphotic patients.
Identifiants
pubmed: 35224673
doi: 10.1007/s00586-022-07145-7
pii: 10.1007/s00586-022-07145-7
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1028-1035Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Weinstein SL, Dolan LA, Cheng JCY et al (2008) Adolescent idiopathic scoliosis. Lancet 371:1527–1537. https://doi.org/10.1016/S0140-6736(08)60658-3
doi: 10.1016/S0140-6736(08)60658-3
pubmed: 18456103
Danielsson AJ, Nachemson AL (2001) Radiologic findings and curve progression 22 years after treatment for adolescent idiopathic scoliosis: comparison of brace and surgical treatment with matching control group of straight individuals. Spine 26:516–525
doi: 10.1097/00007632-200103010-00015
Pesenti S, Jouve J-L, Morin C et al (2015) Evolution of adolescent idiopathic scoliosis: results of a multicenter study at 20 years’ follow-up. Orthop Traumatol Surg Res 101:619–622. https://doi.org/10.1016/j.otsr.2015.05.004
doi: 10.1016/j.otsr.2015.05.004
pubmed: 26194208
Harrington PR (1962) Treatment of scoliosis. Correction and internal fixation by spine instrumentation. J Bone Joint Surg Am 44-A:591–610
Duhaime M, Lebel M, Labelle P et al (1981) The evaluation of the Harrington technique in the treatment of double-curved scoliosis (author’s transl). Rev Chir Orthop Reparatrice Appar Mot 67:99–105
pubmed: 6453407
Lafage V, Schwab F, Skalli W et al (2008) Standing balance and sagittal plane spinal deformity: analysis of spinopelvic and gravity line parameters. Spine 33:1572–1578. https://doi.org/10.1097/BRS.0b013e31817886a2
doi: 10.1097/BRS.0b013e31817886a2
pubmed: 18552673
Cotrel Y, Dubousset J, Guillaumat M (1988) New universal instrumentation in spinal surgery. Clin Orthop Relat Res 227:10–23
doi: 10.1097/00003086-198802000-00004
Benli IT, Akalin S, Aydin E et al (2001) Isola spinal instrumentation system for idiopathic scoliosis. Arch Orthop Trauma Surg 121:17–25. https://doi.org/10.1007/s004020000170
doi: 10.1007/s004020000170
pubmed: 11195113
Steib J-P, Dumas R, Mitton D, Skalli W (2004) Surgical correction of scoliosis by in situ contouring: a detorsion analysis. Spine 29:193–199. https://doi.org/10.1097/01.BRS.0000107233.99835.A4
doi: 10.1097/01.BRS.0000107233.99835.A4
pubmed: 14722414
Chang K-W (2003) Cantilever bending technique for treatment of large and rigid scoliosis. Spine 28:2452–2458. https://doi.org/10.1097/01.BRS.0000092063.63315.D5
doi: 10.1097/01.BRS.0000092063.63315.D5
pubmed: 14595163
Delorme S, Labelle H, Aubin CE, et al (1999) Intraoperative comparison of two instrumentation techniques for the correction of adolescent idiopathic scoliosis. Rod rotation and translation. Spine 24:2011–7; discussion 2018. Doi: https://doi.org/10.1097/00007632-199910010-00009
Delorme S, Labelle H, Aubin CE et al (2000) A three-dimensional radiographic comparison of Cotrel-Dubousset and Colorado instrumentations for the correction of idiopathic scoliosis. Spine 25:205–210. https://doi.org/10.1097/00007632-200001150-00010
doi: 10.1097/00007632-200001150-00010
pubmed: 10685484
Clement J-L, Chau E, Kimkpe C, Vallade M-J (2008) Restoration of thoracic kyphosis by posterior instrumentation in adolescent idiopathic scoliosis: comparative radiographic analysis of two methods of reduction. Spine 33:1579–1587. https://doi.org/10.1097/BRS.0b013e31817886be
doi: 10.1097/BRS.0b013e31817886be
pubmed: 18552674
Ilharreborde B, Even J, Lefevre Y et al (2010) Hybrid constructs for tridimensional correction of the thoracic spine in adolescent idiopathic scoliosis: a comparative analysis of universal clamps versus hooks. Spine 35:306–314. https://doi.org/10.1097/BRS.0b013e3181b7c7c4
doi: 10.1097/BRS.0b013e3181b7c7c4
pubmed: 20075778
Pesenti S, Lafage R, Henry B, et al (2020) Deformity correction in thoracic adolescent idiopathic scoliosis. Bone Joint J 102-B:376–382. Doi : https://doi.org/10.1302/0301-620X.102B3.BJJ-2019-0993.R1
Clément J-L, Solla F, Amorese V et al (2020) Lumbopelvic parameters can be used to predict thoracic kyphosis in adolescents. Eur Spine J 29:2281–2286. https://doi.org/10.1007/s00586-020-06373-z
doi: 10.1007/s00586-020-06373-z
pubmed: 32185541
Glattes RC, Bridwell KH, Lenke LG et al (2005) Proximal junctional kyphosis in adult spinal deformity following long instrumented posterior spinal fusion: incidence, outcomes, and risk factor analysis. Spine 30:1643–1649. https://doi.org/10.1097/01.brs.0000169451.76359.49
doi: 10.1097/01.brs.0000169451.76359.49
pubmed: 16025035
Laumonerie P, Tibbo ME, Kerezoudis P et al (2019) Influence of the sublaminar band density in the treatment of Lenke 1 adolescent idiopathic scoliosis. Orthop Traumatol Surg Res 106:1269–1274. https://doi.org/10.1016/j.otsr.2019.10.021
doi: 10.1016/j.otsr.2019.10.021
pubmed: 31883867
Qadir I, Shah A, Alam SR et al (2020) Impact of metal density on deformity correction in posterior fusions for adolescent idiopathic scoliosis: A retrospective cohort study. Ann Med Surg 52:44–47. https://doi.org/10.1016/j.amsu.2020.02.011
doi: 10.1016/j.amsu.2020.02.011
Şenköylü A, Çetinkaya M, Daldal İ et al (2020) The implant density does not change the correction rate of the main and the accompanying curves: A comparison between consecutive and intermittent pedicle screw constructs. Acta Orthop Traumatol Turc 54:293–299. https://doi.org/10.5152/j.aott.2020.03.16
doi: 10.5152/j.aott.2020.03.16
pubmed: 32544065
pmcid: 7586770
Charalampidis A Möller A, Wretling M-L et al (2018) Implant density is not related to patient-reported outcome in the surgical treatment of patients with idiopathic scoliosis Bone Joint J 100-B:1080–1086. Doi: https://doi.org/10.1302/0301-620X.100B8.BJJ-2017-1114.R1 .
Clements DH, Betz RR, Newton PO et al (2009) Correlation of scoliosis curve correction with the number and type of fixation anchors. Spine 34:2147–2150. https://doi.org/10.1097/BRS.0b013e3181adb35d
doi: 10.1097/BRS.0b013e3181adb35d
pubmed: 19752700
Delman C, Cage JM, Lausé G et al (2020) Anterior and Posterior Fusion for Large, Rigid Idiopathic Scoliosis: Does Implant Density Matter? World Neurosurg 134:e37–e45. https://doi.org/10.1016/j.wneu.2019.08.123
doi: 10.1016/j.wneu.2019.08.123
pubmed: 31470168
Delikaris A, Wang X, Boyer L et al (2018) Implant density at the apex is more important than overall implant density for 3d correction in thoracic adolescent idiopathic scoliosis using rod derotation and en bloc vertebral derotation technique. Spine 43:E639–E647. https://doi.org/10.1097/BRS.0000000000002465
doi: 10.1097/BRS.0000000000002465
pubmed: 29059123
Dial BL, Esposito VR, Catanzano AA et al (2020) Implant distribution versus implant density in lenke type 1 adolescent idiopathic scoliosis: Does the position of the screw matter? Global Spine J 11:2192568220941456. https://doi.org/10.1177/2192568220941456
doi: 10.1177/2192568220941456
Le Navéaux F, Larson AN, Labelle H et al (2018) Significant variability in surgeons’ preferred correction maneuvers and instrumentation strategies when planning adolescent idiopathic scoliosis surgery. Scoliosis Spinal Disord 13:21. https://doi.org/10.1186/s13013-018-0169-8
doi: 10.1186/s13013-018-0169-8
pubmed: 30324149
pmcid: 6174067
Allia J, Clément J-L, Rampal V et al (2018) Influence of derotation connectors on 3D surgical correction of adolescent idiopathic scoliosis. Clin Spine Surg 31:E209–E215. https://doi.org/10.1097/BSD.0000000000000621
doi: 10.1097/BSD.0000000000000621
pubmed: 29494458
Tambe AD, Panikkar SJ, Millner PA, Tsirikos AI (2018) Current concepts in the surgical management of adolescent idiopathic scoliosis. Bone Joint J 100-B:415–424. Doi: https://doi.org/10.1302/0301-620X.100B4.BJJ-2017-0846.R2
Ilharreborde B, Pesenti S, Ferrero E et al (2018) Correction of hypokyphosis in thoracic adolescent idiopathic scoliosis using sublaminar bands: a 3D multicenter study. Eur Spine J 27:350–357. https://doi.org/10.1007/s00586-017-5166-8
doi: 10.1007/s00586-017-5166-8
pubmed: 28612190
Clément J-L, Chau E, Vallade M-J, Geoffray A (2011) Simultaneous translation on two rods is an effective method for correction of hypokyphosis in AIS: radiographic results of 24 hypokyphotic thoracic scoliosis with 2 years minimum follow-up. Eur Spine J 20:1149–1156. https://doi.org/10.1007/s00586-011-1779-5
doi: 10.1007/s00586-011-1779-5
pubmed: 21487775
pmcid: 3176703
Clement J-L, Chau E, Geoffray A, Suisse G (2014) Restoration of thoracic kyphosis by simultaneous translation on two rods for adolescent idiopathic scoliosis. Eur Spine J 23(Suppl 4):S438–S445. https://doi.org/10.1007/s00586-014-3340-9
doi: 10.1007/s00586-014-3340-9
pubmed: 24854726
Pesenti S, Chalopin A, Peltier E et al (2016) How sublaminar bands affect postoperative sagittal alignment in AIS patients with preoperative hypokyphosis? Results of a series of 34 patients with 2-year follow-up. Biomed Res Int 2016:1954712. https://doi.org/10.1155/2016/1954712
doi: 10.1155/2016/1954712
pubmed: 27999791
pmcid: 5141309
Acarogly E, Doany M, Cetin E et al (2019) Correction of rotational deformity and restoration of thoracic kyphosis are inversely related in posterior surgery for adolescent idiopathic scoliosis. Med Hypotheses 133:109396
Schlösser TP, Abelin-Genevois K, Homans J et al (2021) Comparison of different strategies on three-dimensional correction of AIS: which plane will suffer? Eur Spine J 30:645–652. https://doi.org/10.1007/s00586-020-06659-2
doi: 10.1007/s00586-020-06659-2
pubmed: 33355708
Shen F, Zhou B, Li Q et al (2015) Posterior-only spinal release combined with derotation, translation, segmental correction, and an in situ rod-contouring technique for treatment of severe and rigid scoliosis. J Neurosurg Spine 22:194–198. https://doi.org/10.3171/2014.10.SPINE13690
doi: 10.3171/2014.10.SPINE13690
pubmed: 25495943