Gain in Spinal Height from Surgical Correction of Idiopathic Scoliosis

Spencer, Hillard T.; Gold, Meryl; Karlin, Lawrence I.; Hedequist, Daniel; Hresko, M. Timothy

doi:10.2106/jbjs.l.01333

Cited by 24 publications

(57 citation statements)

References 17 publications

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“…Height distraction is due to straightening of scoliosis, and the magnitude of the coronal Cobb correction and the number of fused levels correlated to height gain after posterior corrective fusion. 19 In this study, neither Cobb correction rates nor the number of fused levels were accompanied by cervical alignment. This result may be a reason for the lack of correlation between cervical alignment and height.…”

Section: Discussioncontrasting

confidence: 52%

Cervical lordotic alignment following posterior spinal fusion for adolescent idiopathic scoliosis: reciprocal changes and risk factors for malalignment

Hayashi

Toyoda

Terai

et al. 2017

PED

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OBJECTIVE Numerous reports have been published on the effectiveness and safety of correction of the coronal Cobb angle and thoracolumbar sagittal alignment in patients with adolescent idiopathic scoliosis (AIS). Suboptimal sagittal alignment, such as decreased thoracic kyphosis (TK), after corrective surgery, is a possible cause of lumbar or cervical spinal degeneration and junctional malalignment; however, few reports are available on reciprocal changes outside of the fused segments, such as the cervical lordotic angle (CLA). This study aimed to investigate the relationship between the perioperative CLA and other radiographic factors or clinical results in AIS, and to identify independent risk factors of postoperative cervical hyperkyphosis. METHODS A total of 51 AIS patients who underwent posterior spinal fusion with the placement of pedicle screw (PS) constructs at thoracic levels were included in the study. Clinical and radiographic follow-up of patients was conducted for a minimum of 2 years, and the postoperative course was evaluated. The authors measured and identified the changes in the CLA and other radiographic parameters using whole-spine radiography, with the patient in the standing position, performed immediately before surgery, 2 weeks after surgery, and 2 years after surgery. The postoperative cervical hyperkyphosis group included patients whose CLA at 2-year follow-up was smaller than −10°. The reciprocal changes of the CLA and other parameters were also investigated. Univariate and multivariate analyses were conducted to determine the associated risk factors for postoperative cervical hyperkyphosis. RESULTS This study comprised 48 females and 3 males (mean age 16.0 years). The mean follow-up period was 47 months (range 24–90 months). The main coronal thoracic curve was corrected from 54.6° to 16.4°, and the mean correction rate was 69.8% at 2 years. The CLA significantly increased from the mean preoperative measurement (−5.4° ± 14°) to the 2-year follow-up measurement (−1.7° ± 11°) (p = 0.019). Twelve of the 51 patients had postoperative cervical hyperkyphosis. This group exhibited significantly smaller preoperative CLA and TK measurements (p = 0.001 and 0.004, respectively) than the others. After adjusting for confounding factors, preoperative CLA less than −5° and preoperative TK less than 10° were significantly associated with postoperative cervical hyperkyphosis (p < 0.05; OR 12.5 and 8.59, respectively). However, no differences were found in the clinical results regardless of cervical hyperkyphosis. CONCLUSIONS The CLA increased significantly from preoperatively to 2 years after surgery. Preoperative small CLA and TK measurements were independent risk factors of postoperative cervical hyperkyphosis. However, there was no difference in the clinical outcomes regardless of cervical hyperkyphosis.

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Section: Discussioncontrasting

confidence: 52%

Cervical lordotic alignment following posterior spinal fusion for adolescent idiopathic scoliosis: reciprocal changes and risk factors for malalignment

Hayashi

Toyoda

Terai

et al. 2017

PED

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“…In our case, postoperatively the body height of the patient increased by 8 cm and sitting height of the patient increased by 5 cm, which is higher than the study conducted by spencer et al [ 8 ] Adult scoliosis is a trending problem, which will arise in the future. The decision whether to do surgery or conservatively depends on the subjective and objective measures.…”

Section: Discussioncontrasting

confidence: 70%

Optimization Correction Strength Using Contra Bending Technique without Anterior Release Procedure to Achieve Maximum Correction on Severe Adult Idiopathic Scoliosis

Rahyussalim

Saleh

Purnaning

et al. 2016

Case Reports in Orthopedics

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Adult scoliosis is defined as a spinal deformity in a skeletally mature patient with a Cobb angle of more than 10 degrees in the coronal plain. Posterior-only approach with rod and screw corrective manipulation to add strength of contra bending manipulation has correction achievement similar to that obtained by conventional combined anterior release and posterior approach. It also avoids the complications related to the thoracic approach. We reported a case of 25-year-old male adult idiopathic scoliosis with double curve. It consists of main thoracic curve of 150 degrees and lumbar curve of 89 degrees. His curve underwent direct contra bending posterior approach using rod and screw corrective manipulation technique to achieve optimal correction. After surgery the main thoracic Cobb angle becomes 83 degrees and lumbar Cobb angle becomes 40 degrees, with 5 days length of stay and less than 800 mL blood loss during surgery. There is no complaint at two months after surgery; he has already come back to normal activity with good functional activity.

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“…Several formulas have been proposed by various authors to determine the increase in height after scoliosis correction. [6][7][8][9] However, these formulas are based on a combination of preoperative and post-operative radiological parameters. Using these formulas, the increase in height could only be determined after the surgery.…”

Section: Introductionmentioning

confidence: 99%

Prediction of height increment using preoperative radiological parameters following selective thoracic fusion with alternate-level pedicle screw construct in Lenke 1 and 2 adolescent idiopathic scoliosis patients

Keong

Aziz

Wei

2017

J Orthop Surg (Hong Kong)

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Purpose: This study aims to derive a formula to predict post-operative height increment in Lenke 1 and Lenke 2 adolescent idiopathic scoliosis (AIS) patients using preoperative radiological parameters. Methods: This study involved 70 consecutive Lenke 1 and 2 AIS patients who underwent scoliosis correction with alternate-level pedicle screw instrumentation. Preoperative parameters that were measured included main thoracic (MT) Cobb angle, proximal thoracic (PT) Cobb angle, lumbar Cobb angle as well as thoracic kyphosis. Side-bending flexibility (SBF) and fulcrumbending flexibility (FBF) were derived from the measurements. Preoperative height and post-operative height increment was measured by an independent observer using a standardized method.

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Gain in Spinal Height from Surgical Correction of Idiopathic Scoliosis

Cited by 24 publications

References 17 publications

Cervical lordotic alignment following posterior spinal fusion for adolescent idiopathic scoliosis: reciprocal changes and risk factors for malalignment

Cervical lordotic alignment following posterior spinal fusion for adolescent idiopathic scoliosis: reciprocal changes and risk factors for malalignment

Optimization Correction Strength Using Contra Bending Technique without Anterior Release Procedure to Achieve Maximum Correction on Severe Adult Idiopathic Scoliosis

Prediction of height increment using preoperative radiological parameters following selective thoracic fusion with alternate-level pedicle screw construct in Lenke 1 and 2 adolescent idiopathic scoliosis patients

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