Predictive factors for correction rate in severe idiopathic scoliosis (Cobb angle ≥ 90°): an analysis of 128 patients

Mihara, Yuki; Chung, Weng Hong; Mohamad, Siti Mariam; Chiu, Chee Kidd; Chan, Chris Yin Wei; Kwan, Mun Keong

doi:10.1007/s00586-020-06701-3

Cited by 3 publications

(6 citation statements)

References 28 publications

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“…[ 28 ] After that, several other studies reported very good results (around 55%–60% of major curve correction rate) with one-stage PSF. [ 1 21 35 23 24 26 27 30 31 32 33 ] This is in line with the current literature. In fact, most of the studies on the surgical treatment of severe AIS show contained correction rate values, often lower than 60% regardless of the technique used:[ 2 3 4 5 6 7 8 9 10 ] in these cases, the aim was not to maximize correction but to obtain an acceptable balance of the spine and save levels of fusion.…”

Section: Discussionsupporting

confidence: 84%

“…A total of 1337 studies were found through electronic search; after screening, 14 studies (1 prospective cohort study,[ 23 ] 3 retrospective comparative studies,[ 24 25 26 ] 1 retrospective cohort study,[ 27 ] 6 retrospective studies,[ 28 29 30 31 32 33 ] 1 prospective CS,[ 34 ] and 2 retrospective CS[ 1 21 ]) were included. [ 1 21 23 24 25 26 27 28 30 31 33 34 ] The quality of the papers was good in 13 cases[ 1 21 23 24 25 26 27 28 30 31 33 ] and fair in 1 case.…”

Section: Resultsmentioning

confidence: 99%

“…The included studies chose different criteria for the definition of severe scoliosis: Seven authors used a major curve Cobb >90° as a cutoff[ 24 27 28 30 31 32 33 ] (1 of them[ 30 ] used major curve Cobb >90° and flexibility index <30%), 4 used a major curve Cobb >80°[ 1 21 25 34 ] (2 of them[ 1 34 ] used major curve Cobb >80° and flexibility index <25%), 3 used a major curve Cobb >70°[ 23 26 35 ] [ Table 1 ].…”

Section: Resultsmentioning

confidence: 99%

“…The included studies are heterogeneous in Lenke distribution of the curves, internal fixation devices, and use of Schwab >1 osteotomies[ 36 ] [ Table 1 ]. Lenke type was reported on 549 patients: [ 1 21 34 24 23 24 25 26 27 30 31 32 33 ] 157 Lenke 1 (28.6%), 252 Lenke 2 (45.9%), 50 Lenke 3 (9.1%), 59 Lenke 4 (10.7%), 1 Lenke 5 (0.2%), and 30 Lenke 6 (5.4%). As for constructs, 11 authors used all pedicle screws constructs,[ 1 21 23 24 25 27 28 30 31 32 33 34 ] while 3 preferred hybrid constructs.…”

Section: Resultsmentioning

confidence: 99%

“…Lenke type was reported on 549 patients: [ 1 21 34 24 23 24 25 26 27 30 31 32 33 ] 157 Lenke 1 (28.6%), 252 Lenke 2 (45.9%), 50 Lenke 3 (9.1%), 59 Lenke 4 (10.7%), 1 Lenke 5 (0.2%), and 30 Lenke 6 (5.4%). As for constructs, 11 authors used all pedicle screws constructs,[ 1 21 23 24 25 27 28 30 31 32 33 34 ] while 3 preferred hybrid constructs. [ 25 26 35 ] As for osteotomies, most of the authors only performed partial facetectomies, while Mirzashahi et al .…”

Section: Resultsmentioning

confidence: 99%

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Surgical treatment of severe adolescent idiopathic scoliosis through one-stage posterior-only approach

Traversari

Ruffilli

Barile

et al. 2022

Journal of Craniovertebral Junction and Spine

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The aim of this meta-analysis was to analyze the results of one-stage all-posterior spinal fusion for severe adolescent idiopathic scoliosis (AIS). A systematic search of articles about one-stage posterior spinal fusion for severe AIS was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data about population, pre-and postoperative radiographical data, surgical procedure details, and complications were extracted. Meta-analyses were performed when possible. Fourteen studies (640 patients) were included. The mean Cobb angle of the major curve varied from 80.0 ± 7.3 to 110.8 ± 12.1. The meta analysis showed a comprehensive coronal correction rate of the major curve of 58.6%, a comprehensive operative time of 274.5 min, and a comprehensive estimated intraoperative blood loss of 866.5 mL (95% confidence interval: 659.3–1073.6, I 2 ≈ 0%). A total of 48 complications (5.4%) were reported. Overall, the meta-analysis showed a major complication rate of 4%. In seven cases, revision surgery was needed. Posterior-only approach is effective enough to correct severe curves and can spare the patient possible adverse events due to anterior approach. However, when choosing this approach for severe AIS, screw density needs to be high and posterior column osteotomies may need to be planned to mobilize the spine and maximize correction.

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Section: Discussionsupporting

confidence: 84%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Surgical treatment of severe adolescent idiopathic scoliosis through one-stage posterior-only approach

Traversari

Ruffilli

Barile

et al. 2022

Journal of Craniovertebral Junction and Spine

View full text Add to dashboard Cite

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Autofusion in growing rod surgery for early onset scoliosis; what do we know so far?

Hatem,

Elmorshidy,

Elkot

et al. 2024

SICOT-J

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The evolving landscape of early onset scoliosis management has shifted from the traditional paradigm of early definitive spinal fusion towards modern growth-friendly implants, particularly Growing Rods (GR). Despite the initial classification of GR treatment as a fusionless procedure, the phenomenon of autofusion has emerged as a critical consideration in understanding its outcomes. Studies have demonstrated the presence of autofusion since the early 1980s. The consequences of autofusion are extensive, impacting curve correction, diminishing trunk growth rate, and contributing to the “law of diminishing returns” in growing rod surgery. The literature suggests that autofusion may complicate definitive fusion surgery, leading to prolonged and intricate procedures involving multiple osteotomies. Additionally, it poses challenges in identifying anatomical landmarks during surgery, potentially increasing the risk of complications and revisions. While autofusion poses challenges to achieving optimal outcomes in growing rod treatment, it cannot be considered a standalone replacement for definitive fusion. Recent advances aim to limit autofusion and enhance treatment outcomes. In this review, we will delve into the existing literature on autofusion, examining studies that have documented its presence, probable causes, pathophysiology, potential implications for long-term patient outcomes, and possible new implants and techniques that decrease its incidence.

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Skull-femoral traction followed by osteotomy correction is a safe and effective treatment for severe scoliosis with split cord malformation

Zhao,

Yuan,

et al. 2024

PLoS ONE

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Objective This study aimed to evaluate the safety and efficacy of skull-femoral traction followed by osteotomy correction in patients with severe spinal scoliosis and split cord malformation. Methods We retrospectively analyzed ten cases of severe spinal scoliosis with Pang I type split cord malformation treated between August 2012 and August 2023. Patients underwent skull-femoral traction prior to osteotomy correction. We assessed changes in height, weight, coronal and sagittal Cobb’s angles, and physiological indicators such as vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and blood gas levels before, during, and after treatment. Results Traction duration ranged from 9 to 19 days, with height and weight showing significant increases post-treatment. The coronal Cobb’s angle improved from pre-treatment to post-corrective surgery and remained stable at the final follow-up. Similar improvements were observed in the sagittal plane. Physiological indicators such as VC, FVC, and FEV1, as well as blood gas levels, normalized after treatment. Nutritional status, indicated by triceps skinfold thickness, albumin, and transferrin concentrations, also improved. No neurological complications or device-related complications occurred during or after treatment. Conclusion Skull-femoral traction followed by osteotomy correction is a safe and effective treatment for severe spinal scoliosis with split cord malformation, offering an alternative to high-risk procedures.

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Predictive factors for correction rate in severe idiopathic scoliosis (Cobb angle ≥ 90°): an analysis of 128 patients

Cited by 3 publications

References 28 publications

Surgical treatment of severe adolescent idiopathic scoliosis through one-stage posterior-only approach

Surgical treatment of severe adolescent idiopathic scoliosis through one-stage posterior-only approach

Autofusion in growing rod surgery for early onset scoliosis; what do we know so far?

Skull-femoral traction followed by osteotomy correction is a safe and effective treatment for severe scoliosis with split cord malformation

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