Does curve convexity affect the surgical outcomes of thoracic adolescent idiopathic scoliosis?

被引：2
作者：
Wang W.-J. [1 ]
Huang A.-B. [1 ]
Zhu Z.-Z. [1 ]
Zhu F. [1 ]
Sun X. [1 ]
Qiu Y. [1 ]
机构：
[1] Spine Surgery, Affiliated Drum Tower Hospital, Nanjing University Medical School
来源：
European Journal of Orthopaedic Surgery & Traumatology | 2014年 / 24卷 / Suppl 1期
基金：
中国国家自然科学基金;
关键词：
Adolescent; Correction; Direction; Idiopathic scoliosis; Thoracic;
D O I：
10.1007/s00590-014-1425-0
中图分类号：
学科分类号：
摘要：
Background: Major left thoracic (LT) curve is an atypical type in adolescent idiopathic scoliosis (AIS) and showed independent clinical characteristics and natural history compared to major right thoracic (RT) curve. However, it's unclear whether the convexity of major thoracic curve would affect the surgical outcomes and risk of complications. A retrospective follow-up study was conducted to investigate whether the convexity of major thoracic curve would affect the surgical outcomes of patients with main thoracic AIS. Methods: Twelve LT-AIS patients underwent corrective spinal instrumentation and fusion were retrieved, and twelve patients with main RT-AIS matched for gender, chronological age, curve type, magnitude and surgical strategy were selected as control. All patients underwent at least 2-year follow-up. The pre- and post-operative radiographic parameters, intraoperative data and functional outcome assessed by Scoliosis Research Society questionnaire 22 (SRS-22) were analyzed and compared between two groups. Results: Patients with LT- and RT-AIS presented with similar magnitudes of thoracic curves, flexibility, fusion level and correction rate. Compared with RT-AIS, patients with LT-AIS showed longer operation time (average, 364 vs. 348 min) and larger amount intraoperative estimated blood loss (2,060 vs. 1,720 ml) although the differences were not statistically significant (p > 0.05). With at least 2-year follow-up, patients in two groups showed comparable loss of correction, coronal and sagittal balance, and the sagittal profiles. With regard to functional outcome, the scores of five categories of SRS-22 questionnaire were similar between two groups. No neurological or vascular complication was observed in these patients. Conclusions: The radiographic and functional outcomes of LT-AIS patients underwent operation were comparable to those with RT-AIS. Longer operation time and more intraoperative blood loss may be expected in instrumentation and fusion for patients with LT-AIS, which might be because of the inconvenience on the surgical procedure. © 2014 Springer-Verlag France.
引用
收藏
页码：S103 / S110
页数：7
相关论文
共 43 条
  • [1] Coonrad R.W., Murrell G.A., Motley G., Et al., A logical coronal pattern classification of 2,000 consecutive idiopathic scoliosis cases based on the scoliosis research society-defined apical vertebra, Spine (Phila Pa 1976), 23, pp. 1380-1391, (1998)
  • [2] King H.A., Moe J.H., Bradford D.S., Et al., The selection of fusion levels in thoracic idiopathic scoliosis, J Bone Jt Surg Am, 65, pp. 1302-1313, (1983)
  • [3] Weinstein S.L., Dolan L.A., Cheng J.C., Et al., Adolescent idiopathic scoliosis, Lancet, 371, pp. 1527-1537, (2008)
  • [4] Lenke L.G., Betz R.R., Harms J., Et al., Adolescent idiopathic scoliosis: A new classification to determine extent of spinal arthrodesis, J Bone Jt Surg Am, 83, pp. 1169-1181, (2001)
  • [5] Qiu G., Zhang J., Wang Y., Et al., A new operative classification of idiopathic scoliosis: A Peking Union Medical College method, Spine (Phila Pa 1976), 30, pp. 1419-1426, (2005)
  • [6] Hausmann O.N., Boni T., Pfirrmann C.W., Et al., Preoperative radiological and electrophysiological evaluation in 100 adolescent idiopathic scoliosis patients, Eur Spine J, 12, pp. 501-506, (2003)
  • [7] Inoue M., Minami S., Nakata Y., Et al., Preoperative MRI analysis of patients with idiopathic scoliosis: A prospective study, Spine (Phila Pa 1976), 30, pp. 108-114, (2005)
  • [8] Richards B.S., Sucato D.J., Johnston C.E., Et al., Right thoracic curves in presumed adolescent idiopathic scoliosis: Which clinical and radiographic findings correlate with a preoperative abnormal magnetic resonance image?, Spine (Phila Pa 1976), 35, pp. 1855-1860, (2010)
  • [9] James J.I., Idiopathic scoliosis
  • [10] The prognosis, diagnosis, and operative indications related to curve patterns and the age at onset, J Bone Jt Surg Br, 36, pp. 36-49, (1954)
12345