Comparative Analysis of Combined (First Anterior, Then Posterior) Versus Only Posterior Approach for Treating Severe Scoliosis
| Autor: | Rok Vengust, Matevž Topolovec, Nikša Hero |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
030222 orthopedics
medicine.medical_specialty business.industry Radiography medicine.medical_treatment Retrospective cohort study Scoliosis medicine.disease Institutional review board Posterior approach Surgery 03 medical and health sciences 0302 clinical medicine Spinal fusion medicine Orthopedics and Sports Medicine Neurology (clinical) Anterior approach business Pedicle screw 030217 neurology & neurosurgery |
| Zdroj: | Spine. 42:831-837 |
| ISSN: | 1528-1159 0362-2436 |
| Popis: | A retrospective, one center, institutional review board approved study. Two methods of operative treatments were compared in order to evaluate whether a two-stage approach is justified for correction of bigger idiopathic scoliosis curves. Two stage surgery, combined anterior approach in first operation and posterior instrumentation and correction in the second operation. One stage surgery included only posterior instrumentation and correction. Studies comparing two-stage approach and only posterior approach are rather scarce, with shorter follow up and lack of clinical data. 348 patients with idiopathic scoliosis were operated using CD hybrid instrumentation with pedicle screw and hooks. Only patients with curvatures ≥61° were analyzed and divided in two groups: two stage surgery (N = 30) and one stage surgery (N = 46). The radiographic parameters as well as duration of operation, hospitalization time and number of segments included in fusion and clinical outcome were analyzed. No statistically significant difference was observed in correction between two-stage group (average correction 69%) and only posterior approach group (average correction 66%). However, there were statistically significant differences regarding hospitalization time, duration of the surgery and the number of instrumented segments. Two-stage surgery has only a limited advantage in terms of postoperative correction angle compared to the posterior approach. Posterior instrumentation and correction is satisfactory, especially taking into account that the patient is subjected to only one surgery.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|