Short fusion strategy for thoracolumbar and lumbar adolescent idiopathic scoliosis using anterior dual-rod instrumentation
| Autor: | Hideki Sudo, Yasuhiro Shono, Norimasa Iwasaki, Kiyoshi Kaneda |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Radiography medicine.medical_treatment Idiopathic scoliosis Lumbar vertebrae Scoliosis Bone Nails Thoracic Vertebrae 03 medical and health sciences Young Adult 0302 clinical medicine Lumbar Medicine Humans Orthopedics and Sports Medicine Child Retrospective Studies 030222 orthopedics Lumbar Vertebrae business.industry medicine.disease Vertebra Surgery medicine.anatomical_structure Spinal Fusion Treatment Outcome Spinal fusion Thoracic vertebrae Female business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | The bonejoint journal. (3) |
| ISSN: | 2049-4408 |
| Popis: | Aims A total of 30 patients with thoracolumbar/lumbar adolescent idiopathic scoliosis (AIS) treated between 1989 and 2000 with anterior correction and fusion surgery using dual-rod instrumentation were reviewed. Patients and Methods Radiographic parameters and clinical outcomes were compared among patients with lowest instrumented vertebra (LIV) at the lower end vertebra (LEV; EV group) (n = 13) and those treated by short fusion (S group), with LIV one level proximal to EV (n = 17 patients). Results The allocation of the surgical technique was determined by the flexibility of the TL/L curves and/or neutral vertebrae located one level above LEV as determined on preoperative radiographs. If these requirements were met a short fusion was performed. The mean follow-up period was 21.4 years (16 to 27). The mean correction rate at final follow-up was significantly lower in the S group (74 sd 11%) than in the EV group (88 sd 13%) (p = 0.004).Coronal and sagittal balance, thoracic kyphosis, lumbar lordosis, and clinical outcomes evaluated by the Scoliosis Research Society-22 questionnaire scores were equivalent between the two groups. Conclusion Short fusion strategy, which uses LIV one level proximal to LEV can be considered as an alternative to the conventional strategy, which includes LEV in the fusion, when highly flexible TL/L curves are confirmed and/or neutral vertebrae are located one level above LEV in patients with thoracolumbar/lumbar AIS curves. Take home message: Short fusion strategy can be considered as an alternative to the conventional strategy in patients with thoracolumbar/lumbar AIS curves undergoing anterior spinal fusion with dual-rod instrumentation. Cite this article: Bone Joint J 2016;98-B:402–9. |
| Databáze: | OpenAIRE |
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