Impact of Various Weights in the Intraoperative Skull-Skeletal Traction on Correction of Adolescent Idiopathic Scoliosis
| Autor: | Sofia Magana, So Kato, Ahmed Al-Jahwari, Doron Rabin, Randolph Gray, Sooyong Chua, Sarah A. Bacon, Sam G. Keshen, Ohm Sharma, Stephen J. Lewis, Reinhard Zeller |
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| Rok vydání: | 2019 |
| Předmět: |
Orthodontics
correction rates business.industry medicine.medical_treatment neurophysiological monitoring weight Scoliosis correction Idiopathic scoliosis Original Articles Traction (orthopedics) Skull medicine.anatomical_structure adolescent idiopathic scoliosis Medicine Orthopedics and Sports Medicine Surgery sense organs Neurology (clinical) business Neurophysiological Monitoring intraoperative traction motor-evoked potentials |
| Zdroj: | Global Spine Journal |
| ISSN: | 2192-5690 2192-5682 |
| DOI: | 10.1177/2192568219882348 |
| Popis: | Study Design: A retrospective study. Objectives: Intraoperative skull-skeletal traction (ISST) facilitates the surgical scoliosis correction, but it is also associated with neurological risk. The objective of the present study was to investigate the impact of various traction weights on neurophysiological change and curve correction in surgery for adolescent idiopathic scoliosis (AIS). Methods: A retrospective review of a consecutive series of posterior spinal fusions for AIS patients undergoing corrections with the use of ISST by 2 surgeons in one institution was performed. Intraoperative prone, post-traction radiographs were performed on all cases. The cases were divided into 2 groups, high and low traction weights, based on whether the weight used was ≥35% or Results: The intraoperative correction magnitudes by ISST were significantly larger in the high ISST group than in the low ISST group (35° vs 26°, P < .001). Changes in motor-evoked potential (MEP) were more frequently observed in the high ISST group (47% vs 26%, P = .049). A multivariate analysis showed that high ISST was associated with 3 times higher risk of MEP change (95% confidence interval = 1.1-8.0, P = .03) and higher final postoperative correction rates (68% vs 60%, P = .001). Conclusions: The high ISST for AIS was associated with increased intraoperative and ultimate curve corrections, and potentially facilitated better final correction. However, the high weight group was associated with an increased frequency of intraoperative MEP changes. |
| Databáze: | OpenAIRE |
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