Posterior-only versus combined anterior/posterior fusion in Scheuermann disease: a large retrospective study

Riouallon, Guillaume; Morin, C.; Charles, Yann-Philippe; Roussouly, Pierre; Kreichati, Gaby; Obeid, Ibrahim; Wolff, Stéphane

doi:10.1007/s00586-018-5633-x

Cited by 16 publications

(19 citation statements)

References 29 publications

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“…As presented in Figure 1 , after database search, there were 95 relevant papers included in the first-round literature selection. After study selection, 13 unique studies [ 4 , 6 , 10 , 14 – 22 ] including 586 patients (AP: 300; PO: 286) were identified and included for this meta-analysis. Overall, 6 AP cohorts and 10 PO cohorts were pooled regarding the correction degrees of kyphosis in the analysis, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…As shown in Figure 2 , six studies [ 6 , 10 , 16 , 19 , 21 , 22 ] reported the correction effect by AP and were pooled into the meta-analysis. As a result, pooled correction degrees in AP cohorts were 33.31 (95% CI: 27.48–39.15; I 2 = 86%, P < 0.001).…”

Section: Resultsmentioning

confidence: 99%

“…As shown in Figure 3 , nine studies [ 5 , 6 , 10 , 14 , 17 , 21 , 22 ] reported the correction effect by PO, and one [ 14 ] of the included studies reported two PO cohorts. Thus, totally ten PO cohorts were pooled into the meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

“…As some patients with kyphosis deformity suffer from back pain, we here also incorporated the pain assessment based on the available data. Among all studies included, 4 studies have assessed pain status change and recorded as visual analogue scale (VAS) score [ 6 , 18 , 20 , 21 ]. Riouallon et al [ 6 ] performed a comparative study including 131 patients, 79% cases undergoing correction surgeries because of severe back pain and 21% due to cosmetic disorders.…”

Section: Resultsmentioning

confidence: 99%

“…Although conservative treatment measures are initially applied, surgical treatment is indicated for kyphosis that is over 70–75 degrees, with significant pain that has not responded to conservative management, and/or respiratory problems due to severe kyphosis, and neurological issues [ 3 – 5 ]. The surgical treatment consists of two different ways; one is the combined anterior-posterior approach (AP) and the other is a posterior-only way (PO), with various types of anchors [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Surgical Procedures Used for Correction of Scheuermann’s Kyphosis: A Meta-Analysis

Liu

2021

Pain Research and Management

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Objectives. Scheuermann’s kyphosis can cause severe back pain and cosmetic disorders to patients. Previous studies on surgical procedure selection for correction of Scheuermann’s kyphosis have drawn controversial conclusions. Here, a meta-analysis was performed to figure out a better way between anterior-posterior (AP) combined procedures and posterior-only (PO) procedures. Methods. We searched PubMed database and Ovid database, as well as Cochrane Library (between January 2009 and December 2020, around recent ten years), for studies reporting Scheuermann’s kyphosis correction in an anterior way or a posterior way. Random effects meta-analysis regarding correction degrees and incidence of proximal junctional kyphosis (PJK) was performed. Results. Finally, 13 unique studies including 586 patients (AP: 300; PO: 286) were identified and included for this meta-analysis. Overall, 6 AP cohorts and 10 PO cohorts were pooled regarding the correction degrees of kyphosis in the analysis, respectively. Pooled correction degrees in AP cohorts were 33.31 (95% CI: 27.48–39.15; I2 = 86%, P < 0.001 ) and in PO cohorts were 31.16 (95% CI: 26.97–35.35; I2 = 81.1%, P < 0.001 ). Comparison of correction between AP and PO cohorts did not indicate any significant difference. Likewise, postoperative PJK incidence showed no difference. Back pain can be caused by both AP and PO procedures, but which causes less pain remains to be conclusive. The PO approach showed less blood loss and shorter surgical duration as compared to the AP approach. Conclusions. In summary, this meta-analysis shows similar treatment effects between AP and PO procedures in correcting Scheuermann’s kyphosis, suggesting the advantage of PO procedures due to less blood loss and surgical duration. However, the postoperative complications PJK and distal junctional kyphosis (DJK) cannot be well concluded due to the limitation of existing data.

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