Variability in stable sagittal vertebra (SSV) during full-length biplanar xrays can affect the choice of fusion levels in patients with adolescent idiopathic scoliosis (AIS)
| Autor: | Lawrence G. Lenke, David L. Skaggs, David P. Roye, Michael G. Vitale, Jacob Ball, Michael W Fields, Stephen Plachta, Sushrut Arora, Benjamin D. Roye, Hiroko Matsumoto, Matthew W Konigsberg |
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| Rok vydání: | 2020 |
| Předmět: |
030222 orthopedics
medicine.medical_specialty business.industry Radiography Kyphosis Idiopathic scoliosis medicine.disease Surgical planning Sagittal plane Vertebra 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Coronal plane Orthopedic surgery medicine Orthopedics and Sports Medicine business Nuclear medicine 030217 neurology & neurosurgery |
| Zdroj: | Spine Deformity. 8:1261-1267 |
| ISSN: | 2212-1358 2212-134X |
| DOI: | 10.1007/s43390-020-00166-6 |
| Popis: | Surgical planning for Adolescent Idiopathic Scoliosis (AIS) relies on the coronal and sagittal plane to determine the lowest instrumented vertebra (LIV). Failure to include the stable sagittal vertebra (SSV) within the construct can increase the incidence of postoperative distal junctional kyphosis (DJK). The purpose of this study is to assess the variability of SSV within patients and to identify positional parameters that may lead to its change. This is a case–control study of AIS patients with changes in SSV throughout serial radiographs. Radiographic sagittal parameters and hand positioning for the patients with changes in SSV were compared to patients with stable SSV. Additionally, a subgroup analysis was conducted to compare the positional parameters of only the patients with changes in SSV. 46 patients with a mean age of 15 ± 1.8 years old at the time of surgery were included in this study. 33/76 (43.4%) image pairs were found to have a change in SSV. Positional parameters associated with the more distally measured SSV were found to have a more negative sagittal vertebral axis (p = 0.001), more positive pelvic shift (p = 0.023), and more negative Global Sagittal Axis (p = 0.001) when compared to the more proximally measured SSV. Significant variability exists in the determination of SSV in AIS patients undergoing serial radiographs. Positional parameters associated with the proximal and distally measured SSV also have variability which indicates that posture has a significant impact on this measure. Surgeons need to be aware of SSV variability during preoperative planning and must consider multiple parameters for the determination of LIV. 3. |
| Databáze: | OpenAIRE |
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