Cervical s﻿agittal a﻿lignment in Lenke 1 a﻿dolescent i﻿diopathic s﻿coliosis and a﻿ssessment of its a﻿lteration with s﻿urgery: a r﻿etrospective, m﻿ulti-centric study

Garg, Bhavuk; Mehta, Nishank; Gupta, Anupam; Sugumar, Pon Aravindhan A; Shetty, Ajoy Prasad; Basu, Saumyajit; Jakkepally, Sridhar; Gowda, Somashekhar Doddabhadre; Babu, J Naresh; Chhabra, Harvinder Singh

doi:10.1007/s43390-021-00366-8

Cited by 6 publications

(3 citation statements)

References 29 publications

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“…Current correction techniques using high-density anchors allow for a relevant reduction in the coronal deformity (from 65 to 80%) [8]. In addition to coronal outcomes, sagittal results strongly affect long-term quality of life [9][10][11] and the degeneration of uninstrumented levels for both the cervical [12][13][14][15] and lumbar [16].…”

Section: Introductionmentioning

confidence: 99%

Patient-Specific Surgical Correction of Adolescent Idiopathic Scoliosis: A Systematic Review

Solla,

Ilharreborde,

Clément

et al. 2024

Children

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The restoration of sagittal alignment is fundamental to the surgical correction of adolescent idiopathic scoliosis (AIS). Despite established techniques, some patients present with inadequate postoperative thoracic kyphosis (TK), which may increase the risk of proximal junctional kyphosis (PJK) and imbalance. There is a lack of knowledge concerning the effectiveness of patient-specific rods (PSR) with measured sagittal curves in achieving a TK similar to that planned in AIS surgery, the factors influencing this congruence, and the incidence of PJK after PSR use. This is a systematic review of all types of studies reporting on the PSR surgical correction of AIS, including research articles, proceedings, and gray literature between 2013 and December 2023. From the 28,459 titles identified in the literature search, 81 were assessed for full-text reading, and 7 studies were selected. These included six cohort studies and a comparative study versus standard rods, six monocentric and one multicentric, three prospective and four retrospective studies, all with a scientific evidence level of 4 or 3. They reported a combined total of 355 AIS patients treated with PSR. The minimum follow-up was between 4 and 24 months. These studies all reported a good match between predicted and achieved TK, with the main difference ranging from 0 to 5 degrees, p > 0.05, despite the variability in surgical techniques and the rods’ properties. There was no proximal junctional kyphosis, whereas the current rate from the literature is between 15 and 46% with standard rods. There are no specific complications related to PSR. The exact role of the type of implants is still unknown. The preliminary results are, therefore, encouraging and support the use of PSR in AIS surgery.

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Section: Introductionmentioning

confidence: 99%

Patient-Specific Surgical Correction of Adolescent Idiopathic Scoliosis: A Systematic Review

Solla,

Ilharreborde,

Clément

et al. 2024

Children

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“…The changes in the shape of the thoracolumbar spine in AIS are seen as a bend in the coronal view, a reduction in the thoracic kyphosis and change in the size of the lumbar lordosis when compared to normative data (Newton et al, 2019). This can also be associated with changes in cervical spine alignment (Garg et al, 2021; Tang et al, 2019). The surgical correction of AIS is a procedure where, through the implantation of pedicle screws into the vertebral bodies, with connection to rods which act as internal scaffolding, the shape of the deformed spine is altered to recreate normal anatomy as closely as possible.…”

Section: Introductionmentioning

confidence: 99%

“…Following scoliosis surgery, it is recognised that the change in the three‐dimensional shape of the thoracolumbar spine can result in compensatory changes occurring elsewhere in the spine to maintain a horizontal gaze (Pepke et al, 2019). Whilst the relationships between the different parameters in the spine, along with the changes in those parameters that occur secondary to scoliosis surgery, have been explored using correlation analysis (Garg et al, 2021; Shimizu et al, 2019), a greater understanding of what parameters have the most effect on an individual's cervical spine alignment with AIS is lacking. The sagittal alignment of the cervical spine has import as a contributing factor to the subsequent development of myelopathy and spinal cord compression (Ames et al, 2013; Scheer et al, 2013) amongst other conditions that include difficulties with swallowing and respiratory function (Theologis et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Statistical modelling of how the sagittal alignment of the cervical spine is affected by adolescent idiopathic scoliosis and how scoliosis surgery changes that

2022

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The relationship between the sagittal shape of the cervical spine and that of the thoracolumbar spine is established in the normal spine. Adolescent idiopathic scoliosis (AIS) is recognised as a change in the shape of the spine in both the coronal and sagittal planes. The effects of AIS on the alignment of the cervical spine, including the effects of surgery, has been less well studied. The objective of this study was to identify, using regression analysis, the significant relationships between the alignment of the thoracolumbar spine, in both the coronal and sagittal planes, and the sagittal alignment of the cervical spine in AIS. This study used coronal and sagittal radiographic measures from a group with AIS, both pre and post‐operatively, which were analysed using multiple linear regression methods to identify significant parameters that explain the sagittal shape of the cervical spine. There were 51 pairs of pre and post‐operative radiographs analysed, 40 of which were Lenke 1 curves and 11 Lenke 3 curves. Posterior spinal fusion was performed for all. The significant parameters pre‐operatively were T1 slope, thoracic kyphosis, lumbar lordosis and SVA with an R2 value of 78%. Post‐operatively, the significant parameters were T1 slope, thoracic kyphosis, lumbar lordosis and thoracolumbar scoliosis with an R2 of 63%. The sagittal alignment of the cervical spine in AIS is related to the shape of key parameters in the rest of the spine. Changes in the cervical sagittal shape occur to compensate for changes in shape to the rest of the spine that occur as a consequence of surgery. This has implications for the understanding of how the compensatory mechanisms of the spine are used to maintain a horizontal gaze, along with prediction of the effects of surgery on the shape of the spine.

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Neck and shoulder pain in thoracic adolescent idiopathic scoliosis 10 years after posterior spinal fusion

Ohashi,

Watanabe,

Hirano

et al. 2024

Eur Spine J

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Cervical sagittal alignment in Lenke 1 adolescent idiopathic scoliosis and assessment of its alteration with surgery: a retrospective, multi-centric study

Cited by 6 publications

References 29 publications

Patient-Specific Surgical Correction of Adolescent Idiopathic Scoliosis: A Systematic Review

Patient-Specific Surgical Correction of Adolescent Idiopathic Scoliosis: A Systematic Review

Statistical modelling of how the sagittal alignment of the cervical spine is affected by adolescent idiopathic scoliosis and how scoliosis surgery changes that

Neck and shoulder pain in thoracic adolescent idiopathic scoliosis 10 years after posterior spinal fusion

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Cervical s﻿agittal a﻿lignment in Lenke 1 a﻿dolescent i﻿diopathic s﻿coliosis and a﻿ssessment of its a﻿lteration with s﻿urgery: a r﻿etrospective, m﻿ulti-centric study

Cited by 6 publications

References 29 publications

Patient-Specific Surgical Correction of Adolescent Idiopathic Scoliosis: A Systematic Review

Patient-Specific Surgical Correction of Adolescent Idiopathic Scoliosis: A Systematic Review

Statistical modelling of how the sagittal alignment of the cervical spine is affected by adolescent idiopathic scoliosis and how scoliosis surgery changes that

Neck and shoulder pain in thoracic adolescent idiopathic scoliosis 10 years after posterior spinal fusion

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Cervical sagittal alignment in Lenke 1 adolescent idiopathic scoliosis and assessment of its alteration with surgery: a retrospective, multi-centric study