Achieving Shoulder Balance Using Medial and Lateral Radiological Measures in Adolescent Idiopathic Scoliosis.
adolescent idiopathic scoliosis
lateral shoulder
medial shoulder
radiographic shoulder height
shoulder balance
Journal
The Iowa orthopaedic journal
ISSN: 1555-1377
Titre abrégé: Iowa Orthop J
Pays: United States
ID NLM: 8908272
Informations de publication
Date de publication:
06 2022
06 2022
Historique:
entrez:
13
7
2022
pubmed:
14
7
2022
medline:
15
7
2022
Statut:
ppublish
Résumé
Research has shown that postoperative shoulder imbalance is a common problem after spinal fusion in adolescent idiopathic scoliosis (AIS). The best radiographic predictor has not yet been determined and results are inconsistent. This study was to investigate whether using medial and lateral shoulder parameters can effectively achieve postoperative shoulder balance. A prospective database of AIS undergoing posterior spinal fusion were reviewed. Patient demographics and radiological parameters including radiographic shoulder height (RSH), clavicle angle, T1-tilt and first-rib angle at baseline, 6 weeks and last minimal follow up of 2 years were recorded. Correlations between radiological parameters were assessed using Pearson's correlation coefficients. Multivariable linear models identified predictors associated with increased RSH. 219 patients (mean age:13.7 years; 81.7% female) were included. The mean follow-up time was 2.8 years (range:2.0-7.0). The mean RSH at baseline, 6 weeks and last follow up was improved significantly at 95.8%. Preoperative (r=0.8; p<0.001) and post-operative measurements of RSH at 6-week (r=0.9; p<0.001) and last follow up (r=0.9; p<0.001) correlated strongly with clavicle angle measured at respective time-points. In a multivariable linear model, we noted marginal increase in clavicle angle (+4.3°; p<0.001) to be associated with increased RSH. On the contrary, first rib angle and T1-tilt demonstrated moderate to weak correlation with RSH. Clavicle angle is strongly consistent with RSH. First rib angle and T1-tilt as demonstrate medial shoulder balance are moderate to weak correlation. Leveling T1 tilt and first rib angle do not guarantee the postoperative shoulder balance.
Sections du résumé
Background
Research has shown that postoperative shoulder imbalance is a common problem after spinal fusion in adolescent idiopathic scoliosis (AIS). The best radiographic predictor has not yet been determined and results are inconsistent. This study was to investigate whether using medial and lateral shoulder parameters can effectively achieve postoperative shoulder balance.
Methods
A prospective database of AIS undergoing posterior spinal fusion were reviewed. Patient demographics and radiological parameters including radiographic shoulder height (RSH), clavicle angle, T1-tilt and first-rib angle at baseline, 6 weeks and last minimal follow up of 2 years were recorded. Correlations between radiological parameters were assessed using Pearson's correlation coefficients. Multivariable linear models identified predictors associated with increased RSH.
Results
219 patients (mean age:13.7 years; 81.7% female) were included. The mean follow-up time was 2.8 years (range:2.0-7.0). The mean RSH at baseline, 6 weeks and last follow up was improved significantly at 95.8%. Preoperative (r=0.8; p<0.001) and post-operative measurements of RSH at 6-week (r=0.9; p<0.001) and last follow up (r=0.9; p<0.001) correlated strongly with clavicle angle measured at respective time-points. In a multivariable linear model, we noted marginal increase in clavicle angle (+4.3°; p<0.001) to be associated with increased RSH. On the contrary, first rib angle and T1-tilt demonstrated moderate to weak correlation with RSH.
Conclusion
Clavicle angle is strongly consistent with RSH. First rib angle and T1-tilt as demonstrate medial shoulder balance are moderate to weak correlation. Leveling T1 tilt and first rib angle do not guarantee the postoperative shoulder balance.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
47-51Informations de copyright
Copyright © The Iowa Orthopaedic Journal 2022.
Références
Eur Spine J. 2008 Mar;17(3):348-354
pubmed: 18027001
J Bone Joint Surg Am. 2001 Aug;83(8):1169-81
pubmed: 11507125
Spine (Phila Pa 1976). 2002 Sep 15;27(18):2013-20
pubmed: 12634561
J Pediatr Orthop. 2016 Oct-Nov;36(7):691-4
pubmed: 25955167
Acta Psychiatr Scand. 1974;50(1):50-9
pubmed: 4275025
J Neurosurg Spine. 2009 Mar;10(3):214-9
pubmed: 19320580
Eur Spine J. 2012 Oct;21(10):1978-83
pubmed: 22842954
Eur Spine J. 2021 Mar;30(3):686-691
pubmed: 32405796
Eur Spine J. 2011 Oct;20(10):1780-7
pubmed: 21769446
Spine (Phila Pa 1976). 2012 Nov 15;37(24):E1511-6
pubmed: 22895482
Spine (Phila Pa 1976). 2016 Jul 15;41(14):1122-1127
pubmed: 26863257
Spine (Phila Pa 1976). 1993 Sep 15;18(12):1599-608
pubmed: 8235838
Curr Opin Pediatr. 2009 Feb;21(1):55-64
pubmed: 19242241