Maintenance of spontaneous lumbar curve correction following thoracic fusion of main thoracic curves in adolescent idiopathic scoliosis
| Autor: | Norimasa Iwasaki, Wolfgang Hitzl, S. Y. Shono, Hideki Sudo, Kiyoshi Kaneda, S. Núñez-Pereira, Heiko Koller, M. M. Mayer |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Supine position Adolescent medicine.medical_treatment Vital Capacity Lumbar vertebrae Scoliosis Thoracic Vertebrae Pulmonary function testing 03 medical and health sciences FEV1/FVC ratio Young Adult 0302 clinical medicine Medicine Humans Orthopedics and Sports Medicine Child Retrospective Studies 030222 orthopedics Lumbar Vertebrae business.industry Lumbar Curve medicine.disease Surgery medicine.anatomical_structure Spinal Fusion Spinal fusion Thoracic vertebrae Female business Nuclear medicine 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | The bonejoint journal. (7) |
| ISSN: | 2049-4408 |
| Popis: | Aims The aims of our study were to provide long-term information on the behaviour of the thoracolumbar/lumbar (TL/L) curve after thoracic anterior correction and fusion (ASF) and to determine the impact of ASF on pulmonary function. Patients and Methods A total of 41 patients (four males, 37 females) with main thoracic (MT) adolescent idiopathic scoliosis (AIS) treated with ASF were included. Mean age at surgery was 15.2 years (11 to 27). Mean follow-up period was 13.5 years (10 to 18). Results For the TL/L curve, the mean curve flexibility evaluated with supine pre-operative bending radiographs was 78.6% (standard deviation 16.5%), with no significant loss of correction observed. On comparing patients with an increase of the TL/L curve increase (> 4º, n = 9, 22%) to those without, significant differences were observed in the correction rate of the MT curve at the final follow-up (p = 0.011), correction loss of the MT curve (p = 0.003) and the proportion of patients who had semi-rigid instrumentation (p = 0.003). Pre-operative percentage predicted forced vital capacity (%FVC) was 80%, dropping to 72% at final follow-up (p < 0.001). The Scoliosis Research Society questionnaire score was not significantly different between patients with and without a TL/L curve increase (p = 0.606). Spontaneous lumbar curve correction (SLCC) was maintained up to 18 years following selective ASF in most patients and demonstrated significant correlation with maintenance of MT curve correction. Conclusion Maintenance of MT curve correction using rigid instrumentation provided stable SLCC over time. An observed 8% decrease in %FVC indicates that ASF should be reserved for patients with no or only mild pulmonary impairment. Cite this article: Bone Joint J 2016;98-B:997–1002. |
| Databáze: | OpenAIRE |
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