Evaluation of Cervical Alignment and Its Relationship With Thoracic Kyphosis and Spinopelvic Parameters After Scoliosis Correction Surgery

Self Cite

Objective To evaluate coronal alignment in patients with idiopathic adolescent scoliosis with structured lumbar curves submitted to surgical treatment by comparing coronal alignment in the group fusion up to L3 and the group fusion up to L4. Methods Retrospective cohort study. We evaluated patients submitted to surgical treatment with arthrodesis of the lumbar curve with high density of screws with at least 6 months of follow-up. Radiographically, coronal alignment, shoulder height and functional outcome were analyzed through SRS30 questionnaire. Results A total of 25 patients were analyzed, of which 23 were female and 2 were male, with a mean age of 15.2 years (12 to 29 years) at the time of surgery. The patients were divided into two groups. Group A, n = 15: Distal level of fusion in L3 and Group B, n = 10: distal level of fusion in L4. There was no statistically significant difference between Groups A and B when compared to coronal alignment (balanced vs. unbalanced). However, when compared with the coronal alignment (CA) values, lower values of CA were observed in Group A, with statistical significance. No difference was observed between Groups A and B with respect to the SRS30 questionnaire. Conclusions Patients with idiopathic adolescent scoliosis submitted to arthrodesis of the lumbar curve have a better coronal alignment when the distal fusion level is L3. Level of evidence III; Comparative Retrospective Study (based on prospectively collected data).

Section: Methodsmentioning

confidence: 99%

What Is the Best Distal Level of Arthrodesis in Lumbar Fusion in Patients With Adolescent Idiopathic Scoliosis: L3 or L4?

Daher

Melo²,

Nascimento³

et al. 2019

Self Cite

“…4 In patients with AIS, the increase in Cobb angle above 50 degrees, surgical treatment has been directly indicated, the purpose of which is to contain the progression of the scoliotic curvature and improve the radiographic parameters of the sagittal and coronal planes. 5,6 In the literature, studies have used segmental pedicle screws with spinal derotation maneuver in most scoliosis surgeries in the last two decades. [7][8][9][10] During the surgical correction of adolescent scoliosis, direct vertebral derotation (DVD), combined with rod derotation after pedicle screw instrumentation, allows correction of rotational vertebral body deformity, achieving a sufficient correction angle with a sufficient correction angle a reduced fusion level, minimizing aggravated deformity and growth complications.…”

Section: Introductionmentioning

confidence: 99%

Effect of Surgical Treatment of Scoliotic Curvature on the Spine and Upper Limbs

Santos

Barsotti

et al. 2022

Objectives: Evaluate the surgical treatment of scoliotic curvature effects and sagittal radiographic parameters of the spine and upper limbs after surgical treatment with direct vertebral rotation (DVR) associated with type 1 osteotomy in adolescents with idiopathic scoliosis (AIS). Material and Methods: 41 patients with AIS were evaluated and compared before and after surgery. Scoliosis was confirmed by a radiographic of the spine. The radiographic parameters evaluated were: Cobb angles (proximal and distal thoracic), segmental kyphosis (T5-T12), total kyphosis (T1-T12), cervical lordosis (C2-C7), distance from the center of gravity of the skull to C7 (Cervical VAS), measurement of T1 slope (T1), neck slope, IT slope (AP), angle of the upper chest opening and plumb line C7-S1 (SVA C7-S1). Statistical analysis compared the pre- and post-surgical effects of sagittal cervical and shoulder parameters. Results: After the surgical procedure, significant reductions were observed for the following parameters of spine measurement: proximal and distal thoracic Cobb angle, with a correction of 68% of the main thoracic curve. The measurements of the inclination of the T1 profile and the inclination of the neck also improve after surgery. Regarding the shoulders, there was a reduction in T1 AP slope and intercoracoid angle after surgery. The other radiographic parameters did not show significant differences. Conclusion: Surgical treatment with direct vertebral rotation (DVR) associated with type 1 osteotomy promoted better sagittal radiographic parameters of the thoracic Cobb angles, T1 inclination of the cervical spine, neck inclination, and better shoulder symmetry. Level of Evidence II; Prospective study.

“…2 Scoliosis is characterized as an abnormal condition of the lateral curvature of the spine that affects on average 3% of the population. 3 It is classified into different types, including congenital, neuromuscular, and idiopathic, 4 which corresponds to 65% of the cases. 5,6 Traumatic injuries to the spine and spinal cord can be defined as any injury to a spinal segment with or without involvement of the spinal cord and/ or the nerve roots, reaching annual worldwide rates of 50 cases per million individuals and incurring costs of $300 million per year.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and Mortality of Thoracolumbosacral Spinal Arthrodesis in Brazil: The Last 10 Years

Santos

D²,

Carvalho³

et al. 2020

Objective To describe the epidemiology and mortality of thoracolumbosacral arthrodesis surgery in Brazil in the last 10 years. Methods Study conducted using data from the SIH of the Unified Health System (SUS) covering the time period from 2008 to 2018 for all regions of Brazil. The data obtained were analyzed using the BioStat 5.3 program, using Chi-square statistical tests, observing a p-value <0.05 and a 95% confidence interval. Results A total of 66,631 anterior or posterior approach TLS surgeries were registered. The overall mortality rate was 9.37 deaths per thousand procedures. There are regions with mortality much higher than the national average. The mortality rate increases proportionally with the number of levels involved in posterior arthrodesis. Conclusions The study of the epidemiological profile of thoracolumbosacral arthrodesis is important, especially in a country whose population is heterogeneous but has different mortality rates among regions. Therefore, it is necessary to create measures that identify and prevent the factors that lead to the death of patients undergoing such a procedure. Level of evidence II; Retrospective, analytical, quantitative and descriptive study.