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Sanders, Albert J.; Baumann, Richard W.; Brown, Hugh R.; Johnston, Charles E.; Lenke, Lawrence G.; Sink, Ernest L.

doi:10.1097/00007632-200304010-00015

Cited by 10 publications

(12 citation statements)

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“…Selective fusion has gained popularity over decades. 2,3,5–7 Although both anterior and posterior selective TL/L fusion turned out to be effective treatments for AIS with structural TL/L curve and compensatory thoracic curve, 3,8–15 studies have figured out that the anterior method may result in a higher incidence of kyphosis, pseudarthrosis, and loss of correction. 16 Posterior selective TL/L fusion has many advantages like better curve correction, less loss of correction overtime, less loss of blood, and shorter hospital stays over anterior approach, 12 and it has been widely accepted by spine surgeons in recent years.…”

Section: Discussionmentioning

confidence: 99%

Higher Flexibility and Better Immediate Spontaneous Correction May Not Gain Better Results for Nonstructural Thoracic Curve in Lenke 5C AIS Patients

Zhang

Lin

Wang

et al. 2016

Spine

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Study Design.Retrospective study.Objective.To study the behavior of the unfused thoracic curve in Lenke type 5C during the follow-up and to identify risk factors for its correction loss.Summary of Background Data.Few studies have focused on the spontaneous behaviors of the unfused thoracic curve after selective thoracolumbar or lumbar fusion during the follow-up and the risk factors for spontaneous correction loss.Methods.We retrospectively reviewed 45 patients (41 females and 4 males) with AIS who underwent selective TL/L fusion from 2006 to 2012 in a single institution. The follow-up averaged 36 months (range, 24–105 months). Patients were divided into two groups. Thoracic curves in group A improved or maintained their curve magnitude after spontaneous correction, with a negative or no correction loss during the follow-up. Thoracic curves in group B deteriorated after spontaneous correction with a positive correction loss. Univariate analysis and multivariate analysis were built to identify the risk factors for correction loss of the unfused thoracic curves.Results.The minor thoracic curve was 26° preoperatively. It was corrected to 13° immediately with a spontaneous correction of 48.5%. At final follow-up it was 14° with a correction loss of 1°. Thoracic curves did not deteriorate after spontaneous correction in 23 cases in group A, while 22 cases were identified with thoracic curve progressing in group B. In multivariate analysis, two risk factors were independently associated with thoracic correction loss: higher flexibility and better immediate spontaneous correction rate of thoracic curve.Conclusion.Posterior selective TL/L fusion with pedicle screw constructs is an effective treatment for Lenke 5C AIS patients. Nonstructural thoracic curves with higher flexibility or better immediate correction are more likely to progress during the follow-up and close attentions must be paid to these patients in case of decompensation.Level of Evidence: 4

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Section: Discussionmentioning

confidence: 99%

Higher Flexibility and Better Immediate Spontaneous Correction May Not Gain Better Results for Nonstructural Thoracic Curve in Lenke 5C AIS Patients

Zhang

Lin

Wang

et al. 2016

Spine

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“…In this group, 36 % of our patients who underwent selective thoracolumbar/lumbar anterior spinal fusion sustained adding-on and 29 % showed coronal decompensation. Sanders et al [ 23 ] looked at 49 patients with AIS who underwent selective thoracolumbar/lumbar instrumented spinal fusion and tried to identify factors to predict a satisfactory outcome postoperatively. A TL/L:MT Cobb ratio >1.25 in combination with a MT curve that corrects to <20° on side-bending was the best structural predictor for a good outcome.…”

Section: Discussionmentioning

confidence: 99%

Selective fusion in adolescent idiopathic scoliosis: A radiographic evaluation of risk factors for imbalance

Studer

Awais

Williams

et al. 2015

Journal of Children's Orthopaedics

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Study designRetrospective database, chart and medical imaging review.ObjectivesTo report on the outcome and evaluate possible risk factors for postoperative complications following selective spinal fusion in patients with adolescent idiopathic scoliosis (AIS).Materials and methodsAll patients with AIS who underwent either a selective thoracic or selective thoracolumbar/lumbar spinal fusion at our institution from January 2001 to December 2011 inclusive were included in this study. The minimum postoperative follow-up period of all patients was 2 years.ResultsDuring the 11-year study period, 157 patients with AIS underwent surgery for their progressive spinal deformity. Thirty patients (19 %) had a selective spinal fusion, with 16 patients (group A) having a selective thoracic, and 14 patients (group B) having a selective thoracolumbar/lumbar spinal arthrodesis. In both groups the main postoperative complications were adding-on (25 % group A, 36 % group B) and coronal decompensation (25 % group A, 29 % group B). In group A, no statistically significant risk factors for postoperative complications were identified. In group B, global coronal balance was identified as a significant risk factor for adding-on. Patients with adding-on had significantly higher coronal balance scores (mean 3.6) than those who did not experience adding-on (mean 1.9) (p = 0.03). In addition, those with adding-on had a significantly smaller bending lumbar Cobb angle (mean 15) than those without adding-on (mean 31.6) (p = 0.015). None of the patients who underwent selective spinal fusion required revision surgery.ConclusionAlthough the complication rate after performing a selective spinal fusion is high, the revision rate remains low and the debate whether or not to perform a selective spinal fusion will continue.

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“…Sanders et al [13] found significantly better major and minor curvature correction rates without any neurological problem and improved pulmonary function with posterior pedicle screw instrumentation as compared with segmental hook instrumentation. Betz et al [14] reported that coronal correction and balance were equal in both anterior and posterior groups.…”

Section: Discussionmentioning

confidence: 99%

“…Posterior segmental pedicle screw fixation without anterior release had resulted in satisfactory deformity correction in severe scoliosis without significant loss of curvature correction. In this series, a single posterior procedure obviated the need for the anterior release and eliminated complications related to anterior surgery [13]. …”

Section: Discussionmentioning

confidence: 99%

Comparison of the Combined Anterior-Posterior Approach versus Posterior-Only Approach in Scoliosis Treatment

et al. 2014

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Study DesignThis is descriptive analytical study.PurposeThe present study aims at comparing treatment results found between the two groups comprising of patients who underwent posterior spinal fusion using thoracic pedicle screws and the ones who underwent combined anterior-posterior method, respectively.Overview of LiteratureThere was controversy about surgical techniques including anterior, posterior, or a combined anterior-posterior approaches are applied to treat non-congenital scoliosis with surgical indications.MethodsMedical records of 50 patients suffering from thoracic non-congenital scoliosis with curves exceeding 70° were reviewed. In this study, 25 patients who underwent posterior spinal fusion using thoracic pedicle screws were compared with 25 patients who underwent combined anterior-posterior method.ResultsPatients treated through posterior-only and combined approaches were respectively hospitalized for 11.84±5.18 and 26.5±5.2 days (p=0.001). There was a significant difference between these two groups considering intensive care unit admission duration (p=0.001), correction in sagittal view of X-ray (p=0.01), and number of days the patients underwent traction (0.001). Finally, coronal view was corrected without any significant difference (p=0.2).ConclusionsAccording to our findings, it is hypothesized that posterior-only method is associated with some significant advantages and is an advisable method in patients with severe scoliosis over than 70°.

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Cited by 10 publications

References 0 publications

Higher Flexibility and Better Immediate Spontaneous Correction May Not Gain Better Results for Nonstructural Thoracic Curve in Lenke 5C AIS Patients

Higher Flexibility and Better Immediate Spontaneous Correction May Not Gain Better Results for Nonstructural Thoracic Curve in Lenke 5C AIS Patients

Selective fusion in adolescent idiopathic scoliosis: A radiographic evaluation of risk factors for imbalance

Comparison of the Combined Anterior-Posterior Approach versus Posterior-Only Approach in Scoliosis Treatment

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