Variability in stable sagittal vertebra (SSV) during full-length biplanar xrays can affect the choice of fusion levels in patients with adolescent idiopathic scoliosis (AIS)

被引：3

作者：

Ball, Jacob R. ^{[1
]}

Konigsberg, Matthew W. ^{[1
]}

Plachta, Stephen ^{[1
]}

Fields, Michael W. ^{[1
]}

Matsumoto, Hiroko ^{[1
]}

Roye, Benjamin D. ^{[1
]}

Arora, Sushrut ^{[1
]}

Roye, David P. ^{[1
]}

Lenke, Lawrence G. ^{[1
]}

Skaggs, David L. ^{[2
]}

Vitale, Michael G. ^{[1
]}

机构：

[1] Columbia Univ, Morgan Stanley Childrens Hosp New York Presbyteri, Dept Pediat Orthopaed Surg, ATTN Michael Vitale,Med Ctr, 3959 Broadway,CHONY 8-N, New York, NY 10032 USA

[2] Childrens Hosp Los Angeles, Dept Orthoped Surg, Los Angeles, CA 90027 USA

来源：

SPINE DEFORMITY | 2020年 / 8卷 / 06期

关键词：

Adolescent idiopathic scoliosis; Posterior spinal fusion; Lowest instrumented vertebra; Stable sagittal vertebra; Sagittal parameters; INSTRUMENTED VERTEBRA; PARAMETERS; DEFORMITY; RADIOGRAPH; SELECTION; ALIGNMENT; POSITION;

D O I：

10.1007/s43390-020-00166-6

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

PurposeSurgical planning for Adolescent Idiopathic Scoliosis (AIS) relies on the coronal and sagittal plane to determine the lowest instrumented vertebra (LIV). Failure to include the stable sagittal vertebra (SSV) within the construct can increase the incidence of postoperative distal junctional kyphosis (DJK). The purpose of this study is to assess the variability of SSV within patients and to identify positional parameters that may lead to its change.MethodsThis is a case-control study of AIS patients with changes in SSV throughout serial radiographs. Radiographic sagittal parameters and hand positioning for the patients with changes in SSV were compared to patients with stable SSV. Additionally, a subgroup analysis was conducted to compare the positional parameters of only the patients with changes in SSV.Results46 patients with a mean age of 151.8 years old at the time of surgery were included in this study. 33/76 (43.4%) image pairs were found to have a change in SSV. Positional parameters associated with the more distally measured SSV were found to have a more negative sagittal vertebral axis (p=0.001), more positive pelvic shift (p=0.023), and more negative Global Sagittal Axis (p=0.001) when compared to the more proximally measured SSV.ConclusionSignificant variability exists in the determination of SSV in AIS patients undergoing serial radiographs. Positional parameters associated with the proximal and distally measured SSV also have variability which indicates that posture has a significant impact on this measure. Surgeons need to be aware of SSV variability during preoperative planning and must consider multiple parameters for the determination of LIV.Level of evidence3.

引用

页码：1261 / 1267

页数：7

共 20 条

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