Preoperative and postoperative sagittal plane analysis in adult idiopathic scoliosis in patients older than 40 years of age

Sánchez-Mariscal, Felisa; Gomez-Rice, Alejandro; Rodríguez-López, T.; Zúñiga, Lorenzo; Pizones, Javier; Núñez-García, A.; Izquierdo, Enrique

doi:10.1016/j.spinee.2016.08.007

Cited by 7 publications

(5 citation statements)

References 40 publications

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“…This retrospective matched cohort study included 72 cases of younger adult and adolescent idiopathic thoracic scoliosis operated with STF according to Lenke rules mentioned in AIS. [9][10][11]18 Correction rates of the major thoracic curve in 2 groups were 69.3% and 72.0% respectively without significant difference, though statistical differences were shown in fulcrum flexibility of the major thoracic curve (48.5% vs 59.5%). The results are accordant with other studies.…”

Section: Discussionmentioning

confidence: 89%

“…Furthermore, Ponte osteotomy helps to release the posterior elements and may contribute to the restoration of sagittal alignment. 18 The clinical improvement potential for sagittal lordotic change provided by Ponte osteotomies has been reported to be in the range of 9.3–10.78 per level. 19 , 29 Restoring of normal thoracic kyphosis is of great importance for maintaining lumbar lordosis and preventing sagittal imbalance with aging, especially for adult scoliosis.…”

Section: Discussionmentioning

confidence: 99%

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Is Lenke Rule About Selective Thoracic Fusion Applicable for Younger Adult Idiopathic Scoliosis Under 40 Years of Age: Comparison With Adolescent Patients

Wang

et al. 2022

Global Spine Journal

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Study Design Retrospective study. Objective To evaluate the surgical outcomes of younger adult idiopathic scoliosis patients (YAdIS) with selective thoracic fusion by comparing them with adolescent idiopathic scoliosis (AIS). Methods Seventy-two idiopathic scoliosis patients (36 adults and 36 adolescents) treated by posterior-only all-pedicle screw technique were retrospective reviewed and matched by fusion levels. Radiographic parameters were evaluated preoperatively, postoperatively, and at final follow-up. Operating time, blood loss, transfusion, and complications were noted. The clinical outcome was assessed by the Scoliosis Research Society-22 questionnaire (SRS-22). Results The major thoracic curves in YAdIS and AIS groups were 56.3° ± 9.7°, 53.3° ± 10.1° and corrected to 17.2° ± 7.3°, 14.9° ± 7.5° respectively without significant difference in correction rate (69.3% vs 72.0%). For the lumbar curve, Cobb angles in 2 groups were 35.6° ± 10.1°and 31.4 ± 9.2° preoperatively, and were spontaneously corrected to 18.5° ± 9.0° and 12.6° ± 8.2°.Correction rates were 48.0% and 59.8% ( P < .05). Preoperative and postoperative coronal vertebra alignments (CVA) in the YAdIS group were 20.6 ± 9.7 mm and 16.8 ± 7.9 mm ( P > .05), while in the AIS group was 17.8 ± 10.5 mm and 9.7 ± 8.3 mm ( P < .05). However, sagittal parameters showed significant improvements in thoracic kyphosis in both groups ( P < .05). Complication rates were 25% vs 11.1% ( P = .13) with no significant difference. Preoperative SRS-22 was worse in the YAdIS group than AIS group. All the scores were significantly improved postoperatively in the YAdIS group. However, in the AIS group, only SRS scores improved significantly. Conclusions YAdIS can also be treated very well with selective thoracic fusion based on the Lenke rule used for AIS.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Is Lenke Rule About Selective Thoracic Fusion Applicable for Younger Adult Idiopathic Scoliosis Under 40 Years of Age: Comparison With Adolescent Patients

Wang

et al. 2022

Global Spine Journal

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“…This parallels many previous studies in which younger age was one of the predictors of a favorable outcome in spinal procedures. 12,[24][25][26] Smoking was a predictive factor in univariate analyses. Multiple studies have also shown a negative effect of smoking on the outcomes of lumbar surgery.…”

Section: Discussionmentioning

confidence: 94%

Outcome Predictors of the Transforaminal Endoscopic Spine System Technique for Single-level Lumbar Disk Herniation

et al. 2018

J Neurol Surg A Cent Eur Neurosurg

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“…Better sagittal thoracic hypokyphosis correction in the present study may be due to sparse pedicle screws instead of all pedicle screws. Furthemore, Ponte osteotomy helps to release the posterior elements and may contribute to the restore of sagittal alignment [18]. The clinical improvement potential for sagittal lordotic change provided by Ponte osteotomies has been reported to be in the range of 9.3 to 10.78 per level.…”

Section: Discussionmentioning

confidence: 99%

Is Lenke Rule About Selective Thoracic Fusion Applicable for Younger Adult Idiopathic Scoliosis Under 40 Years of Age: Comparison With Adolescent Patients

Yi¹,

Chen²,

Wang³

et al. 2021

Preprint

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Background To evaluate the surgical outcome of younger adult idiopathic scoliosis patients (YAdIS) with selective thoracic fusion by comparing with adolescent idiopathic scoliosis (AIS). Methods Seventy-two idiopathic scoliosis patients (36 adults and 36 adolescents) treated by posterior-only all-pedicle screw technique at the same institution were retrospective reviewed and matched by curve pattern and curve magnitude. Radiographic parameters were evaluated preoperatively, postoperatively and at ﬁnal follow-up. Operating time, blood loss, transfusion and complications were noted. Clinical outcome was assessed by Scoliosis Research Society-22 questionnaire (SRS-22). Results The major thoracic curves in YAdIS group and AIS group were 56.3°±9.7°, 53.3°±10.1° and corrected to 17.2°±7.3°, 14.9°±7.5° respectively without significant difference of correction rate (69.3% vs. 72.0%). For the lumbar curve, Cobb angles in two groups were 35.6° ± 10.1° and 31.4 ± 9.2° preoperatively, and was spontaneously corrected to 18.5° ± 9.0° and 12.6° ± 8.2°. Correction rates were 48.0% and 59.8% (P＜0.05). Coronal vertebra alignments (CVA) in YAdIS group were 20.6 ± 9.7 mm before surgery and 16.8 ± 7.9 mm after surgery (P＞0.05), while CVA in the AIS group was 17.8 ± 10.5 mm preoperatively and decreased to 9.7 ± 8.3 mm postoperatively (P＜0.05). However, sagittal parameters showed significant improvements in thoracic kyphosis in both groups (P＜0.05). Complication rates were 13.9% vs. 5.6% without significant difference. Preoperative SRS score was worse in the YAdIS group than the AIS group. However, there were no significant differences between the final SRS score. Conclusions YAdIS patients gained similar correction of major thoracic curve as AIS patients, although the curve were stiffer.However,more extensive release technique needed to be done which was associated with longer operation time hospital stay. YAdIS had more complications,though this difference was not statistically significant. Patients with lower SRS score in YAdIS can also be treated very well with selective thoracic fusion surgery.

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Preoperative and postoperative sagittal plane analysis in adult idiopathic scoliosis in patients older than 40 years of age

Cited by 7 publications

References 40 publications

Is Lenke Rule About Selective Thoracic Fusion Applicable for Younger Adult Idiopathic Scoliosis Under 40 Years of Age: Comparison With Adolescent Patients

Is Lenke Rule About Selective Thoracic Fusion Applicable for Younger Adult Idiopathic Scoliosis Under 40 Years of Age: Comparison With Adolescent Patients

Outcome Predictors of the Transforaminal Endoscopic Spine System Technique for Single-level Lumbar Disk Herniation

Is Lenke Rule About Selective Thoracic Fusion Applicable for Younger Adult Idiopathic Scoliosis Under 40 Years of Age: Comparison With Adolescent Patients

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