Comparison of Surgical Outcomes of Lenke Type 1 Idiopathic Scoliosis

Qiu, Yong; Zhu, Feng; Wang, Bin; Yu, Yang; Zhu, Zezhang; Qian, Bangpin; Sun, Xu; Ma, Wei

doi:10.1097/bsd.0b013e3182060337

Cited by 24 publications

(7 citation statements)

References 23 publications

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“…Using VCA for Lenke type 1 IS, Vallespir [14] reported that the coronal correction rate was 73.3%, and Yong Qiu [15] described a coronal correction rate of 71.8%. In our study, although a difference was found in the correction rate of the major curve between the bilateral apical vertebral derotation technique by VCM (84.8%) compared with the VCA technique (78.4%), the coronal correction rates in both groups were satisfactory and higher than the average level reported.…”

Section: Discussionmentioning

confidence: 99%

“…Vertebral coplanar alignment (VCA) was described by Vallespir [14] who utilized the coplanar nature of the x - and z- axes of the spine to correct translation and rotation in patients with scoliosis. Clinical studies have demonstrated the effectiveness of 3D correction for IS using VCA [14,15]. However, few reports to date have compared the bilateral apical vertebral derotation technique by VCM to the VCA technique as assessed by radiographic, functional, and outcome parameters, and technical features in patients with IS.…”

Section: Introductionmentioning

confidence: 99%

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Bilateral apical vertebral derotation technique by vertebral column manipulation compared with vertebral coplanar alignment technique in the correction of lenke type 1 idiopathic scoliosis

Sun

Song

Liu

et al. 2013

BMC Musculoskelet Disord

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BackgroundWidely used rod rotation and translation techniques for idiopathic scoliosis (IS) are effective in correcting spinal coronal deformity. Bilateral apical vertebral derotation technique by vertebral column manipulation (VCM) and vertebral coplanar alignment (VCA) technique are two strategies for three-dimensional (3D) correction for IS. The purpose of this study is to compare the post-surgical results and technical features of the bilateral apical vertebral derotation technique by VCM against the VCA technique in patients with Lenke type 1 IS.MethodsForty-eight patients with Lenke type 1 IS were enrolled in the present prospective clinical assay. They were divided into groups A (bilateral apical vertebral derotation technique by VCM, n=24) and B (VCA technique, n=24). Radiographic parameters measured before and after surgery included the Cobb angle, thoracic kyphosis, and apical vertebral rotation. Scoliosis Research Society (SRS)-22 scores were evaluated during the final follow-up. The differences in the demographics, surgical details, and radiographic measurements between the two groups were determined using a T test. The Mann–Whitney U test was used to evaluate the differences in the SRS-22 scores. A value of P<0.05 was considered statistically significant.ResultsIn the coronal plane, a significant difference was found in the correction rate of the major curve (group A: 84.8%, group B: 78.4%; P=0.045) and in the Cincinnati Correction Index between two groups (group A: 2.21, group B: 1.98; P=0.047). In the sagittal plane, no difference was found in the postoperative thoracic kyphosis between the two groups (P=0.328). In the transverse plane, no difference was found between the two groups in the correction rates of the rotation angle sagittal (P=0.298), rib hump (P=0.934), apical vertebral body-to-rib ratio (P=0.988), or apical rib spread difference (P=0.184). Patients underwent follow up for an average of 21.9 and 22.2 months in groups A and B, respectively. Results obtained at the final follow-up indicated no significant loss of correction. No differences were found in the SRS-22 scores between the two groups. No aortic or neurological complications were observed.ConclusionsThe 3D deformity of the spine was effectively corrected using the bilateral apical vertebral derotation technique by VCM and the VCA technique, and encouraging post-surgical results were obtained for patients with Lenke type 1 IS. The two techniques were effective in allowing 3D correctional force that was applied in different ways.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Bilateral apical vertebral derotation technique by vertebral column manipulation compared with vertebral coplanar alignment technique in the correction of lenke type 1 idiopathic scoliosis

Sun

Song

Liu

et al. 2013

BMC Musculoskelet Disord

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“…Hence, for this group of patients, earlier surgical correction should be considered with the objective to restore thoracic kyphosis. Several techniques have been introduced for the correction of thoracic kyphosis, including meticulous facetectomy for spinal column release, surgery with a higher implant density and a pedicle screw system, and the vertebral coplanar alignment method [ 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Thoracic kyphosis in light of lumbosacral alignment in thoracic adolescent idiopathic scoliosis: recognition of thoracic hypokyphosis and therapeutic implications

Iimura

Ueda

Inami

et al. 2022

BMC Musculoskelet Disord

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Background The uniqueness of spinal sagittal alignment in thoracic adolescent idiopathic scoliosis (AIS), for example, the drastically smaller thoracic kyphosis seen in some patients, has been recognized but not yet fully understood. The purpose of this study was to clarify the characteristics of sagittal alignment of thoracic AIS and to determine the contributing factors. Methods Whole spine radiographs of 83 thoracic AIS patients (73 females) were analyzed. The measured radiographic parameters were the Cobb angle of thoracic scoliosis, thoracic kyphosis (TK), lumbar lordosis (LL), C7 sagittal vertical axis (C7 SVA), pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS). Additionally, max-LL, which was defined as the maximum lordosis angle from the S1 endplate, the inflection point between thoracic kyphosis and lumbar lordosis, and the SVA of the inflection point (IP SVA) were measured. The factors significantly related to a decrease in TK were assessed by stepwise logistic regression analysis. In addition, cluster analysis was performed to classify the global sagittal alignment. Results The significant factors for a decrease in TK were an increase in SS (p = 0.0003, [OR]: 1.16) and a decrease in max-LL (p = 0.0005, [OR]: 0.89). According to the cluster analysis, the global sagittal alignment was categorized into the following three types: Type 1 (low SS, low max-LL, n = 28); Type 2 (high SS, low max-LL, n = 22); and Type 3 (high SS, high max-LL, n = 33). Conclusions In thoracic AIS, a decreased TK corresponded to an increased SS or a decreased max-LL. The sagittal alignment of thoracic AIS patients could be classified into three types based on SS and max-LL. One of these three types includes the unique sagittal profile of very small TK.

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“…Notably, a portion of articles in our literature review described rod rotation and translation primarily from the concave side[ 2 , 3 , 15 ] or primary use of distracting forces. [ 7 , 10 , 12 ] These techniques, which may be routinely employed in surgical correction of idiopathic scoliosis,[ 9 , 13 , 17 , 18 ] may not be as safe for surgical correction of SDCIP. [ 3 , 18 ] We believe that in the setting of abnormal expansile intraspinal pathology, such as residual low-grade glioma or syringomyelia as in the present case, applying distracting forces [ Figure 6 ] as the primary maneuver for correction of scoliotic spinal deformities may pose potential neurovascular risks.…”

Section: Discussionmentioning

confidence: 99%

Surgical correction of pediatric spinal deformities with coexisting intraspinal pathology: A case report and literature review

Li¹,

Anderson²,

Nockels³

2021

Surgical Neurology International

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Background: Surgical correction of spinal deformities with coexisting intraspinal pathology (SDCIP) requires special consideration to minimize risks of further injury to an already abnormal spinal cord. However, there is a paucity of literature on this topic. Here, the authors present a pediatric patient with a residual pilocytic astrocytoma and syringomyelia who underwent surgical correction of progressive postlaminectomy kyphoscoliosis. Techniques employed are compared to those in the literature to compile a set of guidelines for surgical correction of SDCIP. Methods: A systematic MEDLINE search was conducted using the following keywords; “pediatric,” “spinal tumor resection,” “deformity correction,” “postlaminectomy,” “scoliosis correction,” “intraspinal pathology,” “tethered cord,” “syringomyelia,” or “diastematomyelia.” Recommendations for surgical technique for pediatric SDCIP correction were reviewed. Results: The presented case demonstrates recommendations that primarily compressive forces on the convexity of the coronal curve should be used when performing in situ correction of SDCIP. Undercorrection is favored to minimize risks of traction on the abnormal spinal cord. The literature yielded 13 articles describing various intraoperative techniques. Notably, seven articles described use of compressive forces on the convex side of the deformity as the primary mode of correction, while only five articles provided recommendations on how to safely and effectively surgically correct SDCIP. Conclusion: The authors demonstrated with their case analysis and literature review that there are no clear current guidelines regarding the safe and effective techniques for in situ correction and fusion for the management of pediatric SDCIP.

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Comparison of Surgical Outcomes of Lenke Type 1 Idiopathic Scoliosis

Abstract: In treating thoracic scoliosis, the VCA technique could achieve as good correction and clinical outcome as the derotation technique. The advantage lies in its superior renormalization effect of thoracic kyphosis compared with the derotation technique from the concave side.

Cited by 24 publications

References 23 publications

Bilateral apical vertebral derotation technique by vertebral column manipulation compared with vertebral coplanar alignment technique in the correction of lenke type 1 idiopathic scoliosis

Bilateral apical vertebral derotation technique by vertebral column manipulation compared with vertebral coplanar alignment technique in the correction of lenke type 1 idiopathic scoliosis

Thoracic kyphosis in light of lumbosacral alignment in thoracic adolescent idiopathic scoliosis: recognition of thoracic hypokyphosis and therapeutic implications

Surgical correction of pediatric spinal deformities with coexisting intraspinal pathology: A case report and literature review

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