Anterior fusion surgery with overcorrection in the treatment of adolescent idiopathic scoliosis with Lenke 1 AR curve type: how to achieve overcorrection and its effect on postoperative spinal alignment.
1AR
Adolescent idiopathic scoliosis
Anterior surgery
Lenke classification
Overcorrection
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
07 Nov 2023
07 Nov 2023
Historique:
received:
27
06
2023
accepted:
25
10
2023
medline:
9
11
2023
pubmed:
8
11
2023
entrez:
8
11
2023
Statut:
epublish
Résumé
The efficacy of anterior fusion with overcorrection in the instrumented vertebra for Lenke 1 AR type curves has been reported, but how to achieve overcorrection and how overcorrection affects spinal alignment are unclear. The purpose of this study was to identify the factors that cause overcorrection, and to investigate how overcorrection affects postoperative spinal alignment in the surgical treatment of Lenke 1 AR type curves. Patients who had anterior surgery for a Lenke type 1 or 2 and lumbar modifier AR (L4 vertebral tilt to the right) type scoliosis and minimum 2-year follow-up were included. The radiographic data were measured at preoperative, postoperative 1 month, and final follow-up. The UIV-LIV Cobb angle was determined as the Cobb angle between the upper instrumented vertebra (UIV) and the lower instrumented vertebra (LIV), and a negative number for this angle was considered overcorrection. The screw angle was determined to be the sum of the angle formed by the screw axis and the lower and upper endplates in the LIV and UIV, respectively. The change (Δ) in the parameters from postoperative to final follow-up was calculated. The relationships between the UIV-LIV Cobb angle and other radiographic parameters were evaluated by linear regression analyses. Fourteen patients met the inclusion criteria. Their median age was 15.5 years, and the median follow-up period was 53.6 months. The median UIV-LIV Cobb angle was -1.4° at postoperative 1 month. The median screw angle was 4.7°, and overcorrection was achieved in 11 (79%) cases at postoperative 1 month. The screw angle (r Screw placement in the UIV and LIV not parallel to the endplate, but angled, was an effective method to facilitate overcorrection in the instrumented vertebrae. The results of the present study suggest that overcorrection could bring spontaneous improvement of coronal balance below the instrumented segment during the postoperative period.
Sections du résumé
BACKGROUND
BACKGROUND
The efficacy of anterior fusion with overcorrection in the instrumented vertebra for Lenke 1 AR type curves has been reported, but how to achieve overcorrection and how overcorrection affects spinal alignment are unclear. The purpose of this study was to identify the factors that cause overcorrection, and to investigate how overcorrection affects postoperative spinal alignment in the surgical treatment of Lenke 1 AR type curves.
METHODS
METHODS
Patients who had anterior surgery for a Lenke type 1 or 2 and lumbar modifier AR (L4 vertebral tilt to the right) type scoliosis and minimum 2-year follow-up were included. The radiographic data were measured at preoperative, postoperative 1 month, and final follow-up. The UIV-LIV Cobb angle was determined as the Cobb angle between the upper instrumented vertebra (UIV) and the lower instrumented vertebra (LIV), and a negative number for this angle was considered overcorrection. The screw angle was determined to be the sum of the angle formed by the screw axis and the lower and upper endplates in the LIV and UIV, respectively. The change (Δ) in the parameters from postoperative to final follow-up was calculated. The relationships between the UIV-LIV Cobb angle and other radiographic parameters were evaluated by linear regression analyses.
RESULTS
RESULTS
Fourteen patients met the inclusion criteria. Their median age was 15.5 years, and the median follow-up period was 53.6 months. The median UIV-LIV Cobb angle was -1.4° at postoperative 1 month. The median screw angle was 4.7°, and overcorrection was achieved in 11 (79%) cases at postoperative 1 month. The screw angle (r
CONCLUSIONS
CONCLUSIONS
Screw placement in the UIV and LIV not parallel to the endplate, but angled, was an effective method to facilitate overcorrection in the instrumented vertebrae. The results of the present study suggest that overcorrection could bring spontaneous improvement of coronal balance below the instrumented segment during the postoperative period.
Identifiants
pubmed: 37936125
doi: 10.1186/s12891-023-06989-4
pii: 10.1186/s12891-023-06989-4
pmc: PMC10631176
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
865Informations de copyright
© 2023. The Author(s).
Références
J Bone Joint Surg Am. 2001 Aug;83(8):1169-81
pubmed: 11507125
J Neurosurg Spine. 2021 Oct 1;:1-8
pubmed: 34598161
Spine (Phila Pa 1976). 2011 Jun 15;36(14):1113-22
pubmed: 21242876
Spine (Phila Pa 1976). 2002 Mar 15;27(6):604-11
pubmed: 11884908
Spine (Phila Pa 1976). 2012 Jul 15;37(16):1384-90
pubmed: 22322370
Spine (Phila Pa 1976). 2009 May 15;34(11):1162-6
pubmed: 19444064
Spine (Phila Pa 1976). 2019 Jul 1;44(13):E788-E799
pubmed: 31205175
Spine (Phila Pa 1976). 2018 Jun 1;43(11):780-790
pubmed: 28937532
J Orthop Surg Res. 2016 Jul 11;11(1):77
pubmed: 27401875
Spine (Phila Pa 1976). 2008 Nov 1;33(23):2545-51
pubmed: 18923336
J Pediatr Orthop B. 1998 Apr;7(2):124-31
pubmed: 9597587
Spine (Phila Pa 1976). 2013 Apr 20;38(9):737-44
pubmed: 23104198
Spine Deform. 2018 Nov - Dec;6(6):684-690
pubmed: 30348344