Can surgery for adolescent idiopathic scoliosis of less than 50 degrees of main thoracic curve achieve good results?

2018 ◽  
Vol 23 (1) ◽  
pp. 14-19 ◽  
Author(s):  
Tetsuhiko Mimura ◽  
Jun Takahashi ◽  
Shota Ikegami ◽  
Shugo Kuraishi ◽  
Masayuki Shimizu ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Thoracic Curve ◽  
Main Thoracic

Key-Vertebral Screws Strategy for Main Thoracic Curve Correction in Patients With Adolescent Idiopathic Scoliosis

2016 ◽  
Vol 29 (8) ◽  
pp. E434-E441 ◽  
Author(s):  
Jingfeng Li ◽  
Kenneth M.C. Cheung ◽  
Dino Samartzis ◽  
Anne K.B. Ganal-Antonio ◽  
Xiaodong Zhu ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Thoracic Curve ◽  
Curve Correction ◽  
Main Thoracic

Comparison of 5-year outcomes between pedicle screw and hybrid constructs in adolescent idiopathic scoliosis

2012 ◽  
Vol 17 (3) ◽  
pp. 212-219 ◽  
Author(s):  
Steven W. Hwang ◽  
Amer F. Samdani ◽  
Ben Wormser ◽  
Hari Amin ◽  
Jeff S. Kimball ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Thoracic Curve ◽  
Patients Âgés ◽  
Thoracic Curvature ◽  
Main Thoracic

Object Pedicle screw fixation has been theorized to provide better correction of scoliotic deformity, but controversy over the benefits of pedicle screw–only constructs remains, and the longer-term impact of pedicle screw fixation as compared with hybrid constructs is unclear. In this study, a retrospective review of a prospectively collected database was conducted to determine the longer-term impact of pedicle screw fixation as compared with hybrid constructs in patients with adolescent idiopathic scoliosis (AIS). Methods The authors retrospectively reviewed a multicenter database of pediatric patients (ages ≤ 18) from 1995 to 2006 and identified 127 patients with Lenke Type 1–4 AIS curves with a minimum 5 years of follow-up. Patients were divided into 2 cohorts based on whether they had undergone pedicle screw fixation or fixation with hybrid constructs. Results The mean main thoracic curvature of 56.1° ± 13.0°, which corrected to 14.9° ± 9.3°, translated into a mean correction of 73% (p < 0.01). The curve was 19.4° ± 10.6° at 2-year follow-up and 20.5° ± 10.4° at 5 years. When comparing preoperative parameters between the groups, differences were noted in the magnitude of the main thoracic curve (p = 0.04), flexibility of the main thoracic curve (p = 0.02), coronal balance (p = 0.04), T2–12 kyphosis (p = 0.02), and sex (p = 0.02). The pedicle screw cohort had fewer spinal segments instrumented (p < 0.01), fewer anterior releases performed (p = 0.02), and fewer thoracoplasties performed (p < 0.01). By 5 years of follow-up, significant differences were apparent between the two cohorts with respect to upper thoracic curvature (p = 0.01), T2–12 (p = 0.02) and T5–12 (p = 0.02) kyphosis, lumbar lordosis (p < 0.01), and sagittal balance (p = 0.01). Conclusions Although some preoperative differences did exist, outcomes were comparable between hybrid and screw constructs at 2 and 5 years. However, hybrid constructs required more concurrent anterior releases and thoracoplasties to achieve similar results.

scholarly journals RADIOGRAPHICAL ANALYSIS OF FLEXIBILITY OF IDIOPATIC SCOLIOSIS IN PRONO AND SUPINO

2020 ◽  
Vol 19 (1) ◽  
pp. 13-17
Author(s):  
MARCELO PAULO MELO DE SOUZA ◽  
ANDRÉ FLAVIO FREIRE PEREIRA ◽  
TULIO ALBUQUERQUE DE MOURA RANGEL ◽  
RODRIGO CASTRO DE MEDEIROS ◽  
LUCIANO TEMPORAL BORGES CABRAL ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Supine Position ◽  
Thoracic Curve ◽  
Reference Standard ◽  
Lumbar Curve ◽  
Level Of Evidence ◽  
Main Thoracic ◽  
Significant Difference ◽  
The Mean

ABSTRACT Objective To determine if there is a statistically significant difference in the flexibility of the curves in the adolescent idiopathic scoliosis (AIS) by using lateral inclination radiographs in supine or prone decubitus. Methods We evaluated 19 patients with AIS, waiting for surgery. Radiographs of the patients were performed in orthostatic anteroposterior incidences and right and left lateral inclinations in prone and supine decubitus. The comparison between prone and supine decubitus was performed through the flexibility rates of the curves measured in each position. Results The mean flexibility rates measured in lateral inclination radiographs with the patient in the supine position were 54.4% ± 38.8% in the proximal thoracic curve, 45.8% ± 15.6% in the main thoracic curve, and 80.5% ± 20.7% in the thoracolumbar / lumbar curve. When the lateral inclination radiographs were performed with the patient in the prone position, we observed mean flexibility rates of 66.4% ± 34.3% in the proximal thoracic curve, 50.1% ± 12.8% in the main thoracic curve, and 80.6% ± 19.0% in the thoracolumbar / lumbar curve. Conclusion This present study did not find a statistically significant difference between the flexibility rates of the curves in the prone and supine positions, suggesting that the two radiographic methods analyzed are similar in the evaluation of the flexibility of the curves in adolescent idiopathic scoliosis. Level of evidence II; Development of diagnostic criteria in consecutive patients (with “gold” reference standard applied).

Spontaneous Proximal Thoracic Curve Correction After Isolated Fusion of the Main Thoracic Curve in Adolescent Idiopathic Scoliosis

Spine ◽  
2001 ◽  
Vol 26 (18) ◽  
pp. 1966-1975 ◽  
Author(s):  
Timothy R. Kuklo ◽  
Lawrence G. Lenke ◽  
Douglas S. Won ◽  
Eric J. Graham ◽  
Fred A. Sweet ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Thoracic Curve ◽  
Curve Correction ◽  
Main Thoracic

Determination of optimal screw number based on correction angle for main thoracic curve in adolescent idiopathic scoliosis

2019 ◽  
Vol 24 (3) ◽  
pp. 415-419 ◽  
Author(s):  
Masashi Uehara ◽  
Jun Takahashi ◽  
Shota Ikegami ◽  
Hiroki Oba ◽  
Shugo Kuraishi ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Thoracic Curve ◽  
Correction Angle ◽  
Main Thoracic

scholarly journals Correlation analysis between the pulmonary function test and the radiological parameters of the main right thoracic curve in adolescent idiopathic scoliosis

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Yonggang Wang ◽  
Fengguang Yang ◽  
Dongmin Wang ◽  
Haiyan Zhao ◽  
Zhanjun Ma ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Pulmonary Function ◽  
Pulmonary Function Test ◽  
Lung Damage ◽  
Thoracic Curve ◽  
Thoracic Cage ◽  
Radiological Parameters ◽  
Main Thoracic ◽  
Function Test

Abstract Background Scoliosis causes thoracic deformities, and it is necessary to assess these changes in pulmonary function test (PFT). To determine how measurements of spinal and thoracic cage deformities are related to pulmonary function. Methods Seventy-two patients with main right thoracic curvature in adolescent idiopathic scoliosis (AIS) underwent a PFT and a radiological parameter evaluation of spinal and thoracic cage deformities. Simple and multiple linear regressions were also used to note whether a combination of variables might better predict PFT values. Means were compared using the two-sample t test or one-way ANOVA with Tukey’s multiple comparison methods. Results Forced vital capacity (FVC)% predicted had significantly negative correlations with main thoracic curve Cobb (MT-Cobb) (R2 = 0.648, p < 0.001), main thoracic curve-rib hump (MT-RH) (R2 = 0.522, p < 0.001), main thoracic curve apical vertebral body-to-rib ratio (MT-AVB-R) (R2 = 0.536, p < 0.001), and main thoracic curve apical vertebra translation (MT-AVT) (R2 = 0.383, p < 0.001). Multiple regression analysis was performed with FVC% predicted as the dependent variable and MT-Cobb, MT-RH, MT-AVB-R, and MT-AVT as the independent variables. MT-Cobb, MT-RH, MT-AVB-R, and MT-AVT were factors with a significant effect on FVC% predicted (p < 0.001). For 45 patients who had preoperative FVC impairment (FVC% predicted < 80%), their MT-Cobb averaged 76.71°. Twenty-seven patients with normal preoperative FVC (FVC% predicted ≥ 80%) had a smaller mean MT-Cobb of 52.03° (p < 0.001). In other radiological parameters, the impaired FVC group had a MT-AVT of 54.29 mm compared to 38.06 mm for the normal FVC group (p < 0.001). MT-AVB-R averaged 2.92 for the impaired FVC group and 1.78 for the normal FVC group (p < 0.001). MT-RH averaged 28.79 mm for the impaired group and 16.62 mm for the normal group (p < 0.001). Further stratification of preoperative PFT results is divided into three groups. The three groups also showed significant differences in MT-Cobb, MT-RH, MT-AVB-R, and MT-AVT (p < 0.001). Conclusion Severe scoliosis leads to an increased degree of thoracic deformity, which increases the risk of lung damage in AIS. Moreover, a more accurate assessment of pulmonary function is achieved through radiological parameters and PFTs.

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