Anterior instrumentation for adolescent idiopathic scoliosis

Göğüş, Abdullah; Talu, Ufuk; Akman, Şenol; Şar, Cüneyt; Hamzaoğlu, Azmi; Eralp, Levent

doi:10.1007/s002640100274

Cited by 11 publications

(9 citation statements)

References 24 publications

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“…12,21 Lowe et al 12 reported a series of 41 patients with thoracolumbar/lumbar AIS curves who were treated with anterior single-rod constructs. Overall deformity correction was 72%, and 1 asymptomatic pseudarthrosis was observed.…”

Section: Discussionmentioning

confidence: 99%

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Prospective Radiographic and Clinical Outcomes of Dual-Rod Instrumented Anterior Spinal Fusion in Adolescent Idiopathic Scoliosis: Comparison With Single-Rod Constructs

Hurford

Lenke

Lee

et al. 2006

Spine

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Section: Discussionmentioning

confidence: 99%

“…The patients were prospectively evaluated with radiographs and Scoliosis Research Society (SRS) outcome instruments. Average age at surgery was 15.3 years (range [12][13][14][15][16][17][18][19][20][21]. Of the patients, 12 were male, and 48 were female.…”

Section: Methodsmentioning

confidence: 99%

Prospective Radiographic and Clinical Outcomes of Dual-Rod Instrumented Anterior Spinal Fusion in Adolescent Idiopathic Scoliosis: Comparison With Single-Rod Constructs

Hurford

Lenke

Lee

et al. 2006

Spine

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“…[3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] in the AIS group. The normal group consisted of 7 boys (33%) and 14 girls (67%), and the AIS group consisted of 6 boys (29%) and 15 girls (71%).…”

Section: Methodsmentioning

confidence: 99%

“…Studies following both open and thoracoscopic anterior spinal fusion and instrumentation show occasional screw loosening, and pullout and plow (partial axial and tangential pullout) of these anterior screws, 1,14,15 most commonly of the proximal screws. 5,13,16 -18 Recently, Zhang et al 19 showed that the position of anterior vertebral body screws placed using thoracoscopic techniques was dependent on the level of the thoracic spine instrumented in a pig model.…”

mentioning

confidence: 97%

Regional Differences in Anatomical Landmarks for Placing Anterior Instrumentation of the Thoracic Spine in Both Normal Patients and Patients With Adolescent Idiopathic Scoliosis

Zhang¹,

Sucato²

2006

Spine

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It is important to understand the relationship of the rib head to the vertebral body to provide-excellent screw purchase within the vertebral body without risking penetration into the spinal canal. In both normal and AIS groups, the relationship of the rib head to the vertebral body and spinal canal changes so that the rib head is positioned more anteriorly in the cephalad-thoracic spine and more posteriorly in the caudal thoracic spine. When placing anterior thoracic screws, at the cephalad- thoracic spine (T4, T5, T6, and T7), removal of rib heads is recommended to allow for good screw purchase. However, at the caudal thoracic spine (T10-T12), staying anterior to the rib head is important to avoid penetration into the spinal canal.

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“…4,7,[9][10][11]23 It has been associated with a posterior more than an anterior spinal fusion. 8,20 Preserving the posterior soft tissue and ligamentous structure may be useful as a surgical strategy to prevent PJK. Despite reports on the prevalence, outcomes, possible risk factors, and prevention of PJK in adult spinal deformity surgery, these factors remain controversial and are not fully understood.…”

Section: Discussionmentioning

confidence: 99%

Proximal junctional kyphosis and clinical outcomes in adult spinal deformity surgery with fusion from the thoracic spine to the sacrum: a comparison of proximal and distal upper instrumented vertebrae

Maruo

Racine

et al. 2013

SPI

141

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Object Proximal junctional kyphosis (PJK) is a common and significant complication after corrective spinal deformity surgery. The object of this study was to compare—based on clinical outcomes, postoperative proximal junctional kyphosis rates, and prevalence of revision surgery—proximal thoracic (PT) and distal thoracic (DT) upper instrumented vertebra (UIV) in adults who underwent spine fusion to the sacrum for the treatment of spinal deformity. Methods In this retrospective study the authors evaluated clinical and radiographic data from consecutive adults (age > 21 years) with a deformity treated using long instrumented posterior spinal fusion to the sacrum in the period from 2007 to 2009. The PT group included patients in whom the UIV was between T-2 and T-5, whereas the DT group included patients in whom the UIV level was between T-9 and L-1. Perioperative surgical data were compared between the PT and DT groups. Additionally, segmental, regional, and global spinal alignments, as well as the sagittal Cobb angle at the proximal junction, were analyzed on preoperative, early postoperative, and final standing 36-in. radiographs. Patient-reported outcome measurements (visual analog scale, Scoliosis Research Society Patient Questionnaire-22, Oswestry Disability Index, and the 36-Item Short-Form Health Survey) were compared. Results Eighty-nine patients, 22 males and 67 females, had a minimum follow-up of 2 years, and thus were eligible for participation in this study. Sixty-seven patients were in the DT group and 22 were in the PT group. Operative time (p = 0.387) and estimated blood loss (p < 0.05) were slightly higher in the PT group. The overall rate of revision surgery was 48.0% and 54.5% in the DT and PT groups, respectively (p = 0.629). The prevalence of PJK according to radiological criteria was 34% in the DT group and 27% in the PT group (p = 0.609). The percent of patients with PJK that required surgical correction (surgical PJK) was 11.9% (8 of 67) in the DT group and 9.1% (2 of 22) in the PT group (p = 1.0). The onset of surgical PJK was significantly earlier than radiological PJK in the DT group (p < 0.01). The types of PJK were different in the PT and DT groups. Compression fracture at the UIV was more prevalent in the DT group, whereas subluxation was more prevalent in the PT group. Postoperatively, the PT group had less thoracic kyphosis (p = 0.02), less sagittal imbalance (p < 0.01), and less pelvic tilt (p = 0.04). In the DT group, early postoperative radiographs demonstrated that the proximal junctional angle of patients with surgical PJK was greater than in those without PJK and those with radiological PJK (p < 0.01). Clinical outcomes were significantly improved in both groups, and there was no significant difference between the groups. Conclusions Both PT and DT UIVs improve segmental and global sagittal plane alignment as well as patient-reported quality of life in those treated for adult spinal deformity. The prevalence of PJK was not different in the PT and DT groups. However, compression fracture was the mechanism more frequently observed with DT PJK, and subluxation was the mechanism more frequently observed in PT PJK. Strategies to avoid PJK may include vertebral augmentation to prevent fracture at the DT spine and mechanical means to prevent vertebral subluxation at the PT spine.

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Anterior instrumentation for adolescent idiopathic scoliosis

Abstract: Thirty-two patients with adolescent idiopathic scoliosis underwent anterior fusion with rigid single rod (third generation instrumentation) and titanium mesh cages. The mean follow-up was 31 (24-45) months and the mean age was 14.9 years. There were 8 patients with King type

Cited by 11 publications

References 24 publications

Prospective Radiographic and Clinical Outcomes of Dual-Rod Instrumented Anterior Spinal Fusion in Adolescent Idiopathic Scoliosis: Comparison With Single-Rod Constructs

Prospective Radiographic and Clinical Outcomes of Dual-Rod Instrumented Anterior Spinal Fusion in Adolescent Idiopathic Scoliosis: Comparison With Single-Rod Constructs

Regional Differences in Anatomical Landmarks for Placing Anterior Instrumentation of the Thoracic Spine in Both Normal Patients and Patients With Adolescent Idiopathic Scoliosis

Proximal junctional kyphosis and clinical outcomes in adult spinal deformity surgery with fusion from the thoracic spine to the sacrum: a comparison of proximal and distal upper instrumented vertebrae

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