Implication of head position on global sagittal alignment of Adolescent Idiopathic Scoliosis with and without thoracic hypokyphosis after posterior spinal fusion

Author(s):  
KH Yeung ◽  
GCW Man ◽  
W Skalli ◽  
ALH Hung ◽  
TP Lam ◽  
...  
2017 ◽  
Vol 19 (4) ◽  
pp. 440-447 ◽  
Author(s):  
Kazunori Hayashi ◽  
Hiromitsu Toyoda ◽  
Hidetomi Terai ◽  
Akinobu Suzuki ◽  
Masatoshi Hoshino ◽  
...  

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.


2019 ◽  
Vol 40 (7) ◽  
pp. e629-e633
Author(s):  
Andrew B. Harris ◽  
Majd Marrache ◽  
Varun Puvanesarajah ◽  
Micheal Raad ◽  
Richard L. Skolasky ◽  
...  

Spine ◽  
2017 ◽  
Vol 42 (8) ◽  
pp. 603-609 ◽  
Author(s):  
Kazunori Hayashi ◽  
Hidetomi Terai ◽  
Hiromitsu Toyoda ◽  
Akinobu Suzuki ◽  
Masatoshi Hoshino ◽  
...  

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Chris Yuk Kwan Tang ◽  
Vijay H. D. Kamath ◽  
Prudence Wing Hang Cheung ◽  
Jason Pui Yin Cheung

Abstract Background Adolescent idiopathic scoliosis (AIS) is a common spinal deformity. Posterior spinal fusion remains an important surgical treatment for AIS. This study aims to determine the predictive factors for intraoperative blood loss in AIS surgery. Methods Patients who had undergone posterior spinal fusion for adolescent idiopathic scoliosis in a single university hospital were reviewed over a 7-year period. Predictive factors for intra-operative blood loss were studied by multivariate analysis to derive a regression model. Receiver operating characteristic analysis was performed to determine the cut-off values of factors contributing to significant intraoperative blood loss (≥500 ml). Results Two hundred and twelve patients were included. Intraoperative blood loss was found to be correlated with gender (rs = 0.30 (0.17–0.43)), preoperative hemoglobin level (rs = 0.20 (0.04–0.31)), preoperative Cobb angle (rs = 0.20 (0.02–0.29)), number of fused levels (rs = 0.46 (0.34–0.58)), operation duration (rs = 0.65 (0.54–0.75)), number of anchors (rs = 0.47 (0.35–0.59)), and p-value ranged from < 0.001 to < 0.05. Significant intraoperative blood loss was influenced by the male gender, operation duration greater than 257.5 min and more than 10 anchors used. Conclusions Male gender, increased operation duration and higher number of anchors predicted higher intra-operative blood loss.


Author(s):  
Aladine A. Elsamadicy ◽  
Isaac G. Freedman ◽  
Andrew B. Koo ◽  
Wyatt B. David ◽  
John Havlik ◽  
...  

2018 ◽  
Vol 6 (2) ◽  
pp. 137-140 ◽  
Author(s):  
Lawrence L. Haber ◽  
Erika D. Womack ◽  
Madhankumar Sathyamoorthy ◽  
James A. Moss ◽  
Michael Wade Shrader

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