Is there an optimal upper instrumented vertebra (UIV) tilt angle to prevent post-operative shoulder imbalance and neck tilt in Lenke 1 and 2 adolescent idiopathic scoliosis (AIS) patients?
| Autor: | Chris Yin Wei Chan, Mun Keong Kwan |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Male
Shoulder Supine position Adolescent Radiography medicine.medical_treatment Idiopathic scoliosis Scoliosis 03 medical and health sciences 0302 clinical medicine Postoperative Complications Medicine Humans Orthopedics and Sports Medicine Prospective Studies Orthodontics 030222 orthopedics business.industry Anatomy medicine.disease Vertebra Tilt (optics) medicine.anatomical_structure Spinal Fusion Clavicle Spinal fusion Surgery Female business 030217 neurology & neurosurgery Neck Follow-Up Studies |
| Zdroj: | European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 25(10) |
| ISSN: | 1432-0932 |
| Popis: | To investigate whether an optimal upper instrumented vertebra (UIV) tilt angle would prevent ‘lateral’ shoulder imbalance or neck tilt (with ‘medial’ shoulder imbalance) post-operatively. The mean follow-up for 60 AIS (Lenke 1 and Lenke 2) patients was 49.3 ± 8.4 months. Optimal UIV tilt angle was calculated from the cervical supine side bending radiographs. Lateral shoulder imbalance was graded using the clinical shoulder grading. The clinical neck tilt grading was as follows: Grade 0: no neck tilt, Grade 1: actively correctable neck tilt, Grade 2: neck tilt that cannot be corrected by active contraction and Grade 3: severe neck tilt with trapezial asymmetry >1 cm. T1 tilt, clavicle angle and cervical axis were measured. UIVDiff (difference between post-operative UIV tilt and pre-operative Optimal UIV tilt) and the reserve motion of the UIV were correlated with the outcome measures. Patients were assessed at 6 weeks and at final follow-up with a minimum follow-up duration of 24 months. Among patients with grade 0 neck tilt, 88.2 % of patients had the UIV tilt angle within the reserve motion range. This percentage dropped to 75.0 % in patients with grade 1 neck tilt whereas in patients with grade 2 and grade 3 neck tilt, the percentage dropped further to 22.2 and 20.0 % (p = 0.000). The occurrence of grade 2 and 3 neck tilt when UIVDiff was 10° was 9.5, 50.0 and 100.0 %, respectively (p = 0.005). UIVDiff and T1 tilt had a positive and strong correlation (r 2 = 0.618). However, UIVDiff had poor correlation with clavicle angle and the lateral shoulder imbalance. An optimal UIV tilt might prevent neck tilt with ‘medial’ shoulder imbalance due to trapezial prominence and but not ‘lateral’ shoulder imbalance. |
| Databáze: | OpenAIRE |
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