Cervical and Thoracic Sagittal Misalignment After Surgery for Adolescent Idiopathic Scoliosis

Legarreta, Carlos; Barrios, Carlos; Rositto, Gabriel; Reviriego, Juan; Maruenda, J. I.; Escalada, María; Pizá-Vallespir, Gabriel; Burgos, Jesús; Hevia, Eduardo

doi:10.1097/brs.0000000000000403

Cited by 30 publications

(32 citation statements)

References 28 publications

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“…Similar relations were also found in some recent studies [11–13]. Thereafter, Legarreta et al [14] found that both pedicle screws and hybrid instrumentation (hooks and pedicle screws) have a hypokyphotic effect on the thoracic spine, which could lead to the occurrence of CK after the surgery, especially in cases in which the upper instrumented vertebra (UIV) is above the T4 level. However, Yanik et al [15] indicated that the postoperative CK was correlated with the decreased TK and T1 slope, nor UIV level.…”

Section: Introductionsupporting

confidence: 76%

“…Both pedicle screws and hybrid instrumentation (hooks and pedicle screws) have a hypokyphotic effect on the thoracic spine, which could lead to the occurrence of CK after the surgery [14, 18]. In this study, all 50 patients underwent surgical treatment with 1-stage posterior pedicle-screw correction and fusion.…”

Section: Discussionmentioning

confidence: 99%

“…The relation between the upper instrumented vertebra (UIV) level and cervical alignment has been evaluated in some studies [14, 15, 18]. Legarreta et al [14] found that cervical kyphosis induced by scoliosis correction was correlated with the level of the UIV, especially in cases in which the UIV is above the T4 level.…”

Section: Discussionmentioning

confidence: 99%

“…Legarreta et al [14] found that cervical kyphosis induced by scoliosis correction was correlated with the level of the UIV, especially in cases in which the UIV is above the T4 level. However, Yanik et al [15] indicated that the postoperative CK was independent from UIV level.…”

Section: Discussionmentioning

confidence: 99%

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Cervical kyphosis in patients with Lenke type 1 adolescent idiopathic scoliosis: the prediction of thoracic inlet angle

Zhu

Yang

Zhou

et al. 2017

BMC Musculoskelet Disord

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BackgroundSeveral studies have explored cervical kyphosis (CK) in adolescent idiopathic scoliosis (AIS) patients. However, few studies have evaluated the cervical alignment in these patients according to their coronal curve type. The aim of this study was to analyze the radiological features of cervical sagittal alignment in Lenke 1 AIS patients before and after surgery.MethodsThis is a retrospective study enrolled 50 patients. Preoperative and postoperative standing full-length radiographs (at last follow-up after operation) were used to measure the coronal and sagittal parameters. Main sagittal parameters included C2–C7 angle, thoracic inlet angle (TIA), T1 slope, proximal thoracic kyphosis (PTK, T1-5 kyphosis) and thoracic kyphosis (TK, T5-12 kyphosis).ResultsThe TIA of patients with CK was significantly smaller than that of patients with CL (63.0° vs. 76.3°, p < 0.05) and the cutoff value was 71°. The TIA of patients with CK after surgery was significantly smaller than that of patients with CL postoperatively (62.5° vs. 74.6°, p < 0.05) and the cutoff value was 62°. In patients with postoperative CL, there was a significant increase in their PTK and a reduction in their TK, regardless of preoperative CL or CK. In patients whose CL deteriorated to CK after surgery, both their PTK and TK significantly decreased after surgery.ConclusionsPatients with TIA less than 71° were more likely to have CK. And patients with TIA less than 62° would lead to the postoperative uncorrected or new onset of CK. The increased PTK after operation could have a beneficial effect on the improvement of CL.

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Section: Introductionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Cervical kyphosis in patients with Lenke type 1 adolescent idiopathic scoliosis: the prediction of thoracic inlet angle

Zhu

Yang

Zhou

et al. 2017

BMC Musculoskelet Disord

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“…Currently there are no published studies that document the actual incidence of these long-term degenerative complications. However, anecdotal clinical evidence suggests that many years after surgery there are increasing numbers of patients with disabling mechanical back pain secondary to degeneration at the junctional levels [6] . Eventually, further fusion surgery may be required to treat these patients.…”

Section: Introductionmentioning

confidence: 99%

Retention of Spinal Mobility and Growth after Correction of Lordo-Scoliosis; Preliminary Assessment of a Novel Implant Device

Hodgson

McMillan²,

Martin³

et al. 2019

International Journal of Orthopaedics

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forces to its adjacent modules. The cumulative effect was the application of de-rotational forces to the deformed spine. For a "proof of concept" investigation, a right thoracic lordo-scoliosis was formed in lambs using an implanted cable as a tether secured on the left side between pedicle screws. After tether removal, 15 lambs with stable scoliotic curves underwent implantation of the modules at each of the segments along the abnormal curve. Animals were euthanased at skeletal maturity. RESULTS: Serial radiographic measurements over two years, revealed an average of 76% coronal plane correction in 12 of the 15 lambs. Specimens demonstrated independent segmental mobility though three animals had adjacent segmental fusion at two levels. Longitudinal spinal growth over the instrumented region averaged 3.9 cm. CONCLUSION: The novel implant dynamically corrected an induced lordo-scoliosis in 12 lambs whilst permitting continued spinal growth and preserving spinal mobility.

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Evidence-Based Treatment of Adolescent Idiopathic Scoliosis

Lebel¹

2016

Paediatric Orthopaedics

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Cervical and Thoracic Sagittal Misalignment After Surgery for Adolescent Idiopathic Scoliosis

Cited by 30 publications

References 28 publications

Cervical kyphosis in patients with Lenke type 1 adolescent idiopathic scoliosis: the prediction of thoracic inlet angle

Cervical kyphosis in patients with Lenke type 1 adolescent idiopathic scoliosis: the prediction of thoracic inlet angle

Retention of Spinal Mobility and Growth after Correction of Lordo-Scoliosis; Preliminary Assessment of a Novel Implant Device

Evidence-Based Treatment of Adolescent Idiopathic Scoliosis

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