Coronal decompensation following thoracic vertebral body tethering in idiopathic scoliosis

被引:1
作者
Ogura, Yoji [1 ]
Larson, A. Noelle [2 ]
Blakemore, Laurel [3 ]
Miyanji, Firoz [4 ]
Andras, Lindsay M. [5 ]
Parent, Stefan [6 ]
El-Hawary, Ron [7 ]
Welborn, Michelle Cameron [8 ]
机构
[1] Keio Univ, Sch Med, Dept Orthopaed Surg, Tokyo, Japan
[2] Coll Med & Sci, Dept Pediat Orthoped Surg, Mayo Clin, Rochester, MN USA
[3] Pediat Specialists Virginia, Dept Pediat Orthopaed Surg, Merrifield, VA USA
[4] Univ British Columbia, Dept Orthopaed, Vancouver, BC, Canada
[5] Childrens Hosp Los Angeles, Dept Orthoped Surg, Los Angeles, CA USA
[6] Dept Orthopaed Surg, Hosp Ste Justine HSJ, Montreal, PQ, Canada
[7] IWK Hlth Ctr, Dept Orthopaed Surg, Halifax, NS, Canada
[8] Shriners Hosp Children Portland, 3101 SW Sam Jackson Pk Rd, Portland, OR 97239 USA
关键词
Anterior vertebral body tethering; Coronal decompensation; Adding-on; Idiopathic scoliosis; LIV selection; Neutral vertebra; Stable vertebra; DISTAL ADDING-ON; RISK-FACTORS; LENKE; 1C; FUSION; CURVES;
D O I
10.1007/s43390-024-00855-6
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Purpose Post-operative coronal decompensation (CD) continues to be a challenge in the treatment of adolescent idiopathic scoliosis (AIS). CD following selective spinal fusion has been studied. However, there is currently little information regarding CD following Vertebral Body Tethering (VBT). Thus, the goal of this study is to better understand the incidence and risk factors for CD after VBT. Methods Retrospective review of a prospective multicenter database was used for analysis. Inclusion criteria were patients undergoing thoracic VBT, a minimum 2-year follow-up, LIV was L1 or above, skeletally immature (Risser <= 1), and available preoperative and final follow-up AP and lateral upright radiographs. Radiographic parameters including major and minor Cobb angles, curve type, LIV tilt/translation, L4 tilt, and coronal balance were measured. CD was defined as the distance between C7PL and CSVL > 2 cm. Multiple logistic regression model was used to identify significant predictors of CD. Results Out of 136 patients undergoing VBT, 94 patients (86 female and 6 male) met the inclusion criteria. The mean age at surgery was 12.1 (9-16) and mean follow-up period was 3.4 years (2-5 years). Major and minor curves, AVR, coronal balance, LIV translation, LIV tilt, L4 tilt were significantly improved after surgery. CD occurred in 11% at final follow-up. Lenke 1A-R (24%) and 1C (26%) had greater incidence of CD compared to 1A-L (4%), 2 (0%), and 3 (0%). LIV selection was not associated with CD. Multivariate logistic regression analysis yielded 1A-R and 1C curves as a predictor of CD with the odds ratio being 17.0. Conclusion CD occurred in 11% of our thoracic VBT patients. Lenke 1A-R and 1C curve types were predictors for CD in patients treated with VBT. There were no other preoperative predictors associated with CD.
引用
收藏
页码:1025 / 1031
页数:7
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