Selective Anterior Thoracolumbar Fusion in Adolescent Idiopathic Scoliosis
| Autor: | Lorenzo Zúñiga, Felisa Sánchez-Mariscal, Renato Delfino, Javier Pizones, Enrique Izquierdo, Cristina Ruiz-Juretschke |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Adolescent Radiography Thoracic Vertebrae Cohort Studies Young Adult 03 medical and health sciences 0302 clinical medicine Lumbar medicine Humans Orthopedics and Sports Medicine Prospective Studies Child Prospective cohort study Retrospective Studies 030222 orthopedics Lumbar Vertebrae business.industry Retrospective cohort study Sagittal plane Surgery Vertebra Spinal Fusion medicine.anatomical_structure Scoliosis Coronal plane Female Neurology (clinical) business 030217 neurology & neurosurgery Follow-Up Studies Cohort study |
| Zdroj: | Spine. 42:E788-E794 |
| ISSN: | 1528-1159 0362-2436 |
| DOI: | 10.1097/brs.0000000000001973 |
| Popis: | Study design Prospectively updated long-term data and retrospective case series analysis. Objective To report the long-term results of selective anterior instrumented thoracolumbar (ThL) fusion in adolescent idiopathic scoliosis (AIS). Summary of background data The results of anterior selective fusion in AIS have been reported up to 2 and 5 years follow-up. However, there is a lack of evidence of long-term results of this surgical approach. Methods Forty-two consecutive patients with main thoracolumbar/lumbar AIS who had undergone surgery for a selective anterior ThL instrumented fusion with more than 12 years of follow-up met inclusion criteria. Preoperative, postoperative (1-yr), and final updated radiographic parameters were recorded. Final ODI and SRS-22 questionnaires were evaluated. Results Thirty-five patients were finally recruited (5 were lost and 2 refused). The mean age at surgery was 16.6 years. The mean final follow-up was 17.3 years (12-24 yr).The ThL preoperative Cobb was 49.5° ± 9, obtaining a postoperative correction of 79%±13 and final correction of 72% ± 18. The preoperative thoracic curve (31.4° ± 14.2) obtained a spontaneous postoperative correction to 18.4° ± 11.9, maintained at final follow-up (17.8° ± 10.8). Apical vertebral rotation improved from 25.8° ± 7.8 to 9.2° ± 5.5 and finally to 8° ± 5.2 (P = 0.001). Sagittal parameters (T5-T12 = 27.2° and L1-S1=56.9°) did not change significantly postoperatively nor by final follow-up. Coronal balance improved from 2.4 cm to 1.6 cm postoperatively and 0.8 cm at final follow-up (P = 0.006). The disc angulation below the last instrumented vertebra improved with follow-up from 7.6° to 5.7° (P = 0.012).There were no revision surgeries or infections. One patient showed a symptomatic lower disc degeneration requiring lumbar pain surgery. Final SRS-22 global score was 4.3/5. The final ODI scored 6/100. Conclusion In the long term, selective anterior thoracolumbar instrumentation with a single solid rod in AIS maintained good corrections on the three planes with no major complications or infections, no revision surgeries, and with satisfactory final functional and clinical outcomes. Level of evidence 4. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|