Abstract
STUDY DESIGN.: A retrospective comparative study. OBJECTIVE.: To analyze the exact distal fusion level in the treatment of major thoracolumbar and lumbar (TL/L) adolescent idiopathic scoliosis (AIS) using rod derotation (RD) and direct vertebral rotation (DVR) following pedicle screw instrumentation (PSI). SUMMARY OF BACKGROUND DATA.: Proper determination of distal fusion level is a very important factor in deformity correction and preservation of motion segments in the treatment of major TL/L AIS. METHODS.: AIS patients with major TL/L curves (n?=?64) treated by PSI with RD and DVR methods with a minimum 2-year follow-up were divided into AL3 (flexible) and BL3 (rigid) according to the flexibility and rotation by preoperative bending radiographs. RESULTS.: There was no significant difference in TL/L (major) curve between the AL3 and BL3 groups postoperatively (P?=?0.933) and at the last follow-up (P?=?0.144). Additionally, there was no significant difference in thoracic (minor) and compensatory (caudal) curve postoperatively (thoracic curve: P?=?0.828, compensatory curve: P?=?0.976); however, there was a significant difference in compensatory (caudal) curve at the last follow-up (P?=?0.041). The overall prevalence of unsatisfactory results was 28.1% (18/64 patients), and the prevalence was 15.2% (7/46) in the AL3 group and 61.1% (11/18) in the BL3 group, which was significantly different (P?<?0.05). CONCLUSIONS.: LIV would be selected at L3 (EV) when the curve is flexible; L3 crosses CSVL with a rotation of less than grade II in preoperative bending radiographs. However, if the curve is rigid, LIV should be extended to L4 (EV?+?1) in order to prevent the adding-on phenomenon in the treatment of major TL/L AIS using RD and DVR following PSI.Level of Evidence: 4
| Original language | English (US) |
|---|---|
| Journal | Spine |
| DOIs | |
| State | Accepted/In press - Nov 22 2016 |
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ASJC Scopus subject areas
- Orthopedics and Sports Medicine
- Clinical Neurology
Cite this
Importance of Distal Fusion Level in Major Thoracolumbar and Lumbar Adolescent Idiopathic Scoliosis Treated by Rod Derotation and Direct Vertebral Rotation Following Pedicle Screw Instrumentation. / Chang, Dong Gune; Yang, Jae Hyuk; Suk, Se Il; Suh, Seung Woo; Kim, Young Hoon; Cho, Woojin; Jeong, Yeon Seok; Kim, Jin Hyok; Ha, Kee Yong; Lee, Jung Hee.
In: Spine, 22.11.2016.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Importance of Distal Fusion Level in Major Thoracolumbar and Lumbar Adolescent Idiopathic Scoliosis Treated by Rod Derotation and Direct Vertebral Rotation Following Pedicle Screw Instrumentation
AU - Chang, Dong Gune
AU - Yang, Jae Hyuk
AU - Suk, Se Il
AU - Suh, Seung Woo
AU - Kim, Young Hoon
AU - Cho, Woojin
AU - Jeong, Yeon Seok
AU - Kim, Jin Hyok
AU - Ha, Kee Yong
AU - Lee, Jung Hee
PY - 2016/11/22
Y1 - 2016/11/22
N2 - STUDY DESIGN.: A retrospective comparative study. OBJECTIVE.: To analyze the exact distal fusion level in the treatment of major thoracolumbar and lumbar (TL/L) adolescent idiopathic scoliosis (AIS) using rod derotation (RD) and direct vertebral rotation (DVR) following pedicle screw instrumentation (PSI). SUMMARY OF BACKGROUND DATA.: Proper determination of distal fusion level is a very important factor in deformity correction and preservation of motion segments in the treatment of major TL/L AIS. METHODS.: AIS patients with major TL/L curves (n?=?64) treated by PSI with RD and DVR methods with a minimum 2-year follow-up were divided into AL3 (flexible) and BL3 (rigid) according to the flexibility and rotation by preoperative bending radiographs. RESULTS.: There was no significant difference in TL/L (major) curve between the AL3 and BL3 groups postoperatively (P?=?0.933) and at the last follow-up (P?=?0.144). Additionally, there was no significant difference in thoracic (minor) and compensatory (caudal) curve postoperatively (thoracic curve: P?=?0.828, compensatory curve: P?=?0.976); however, there was a significant difference in compensatory (caudal) curve at the last follow-up (P?=?0.041). The overall prevalence of unsatisfactory results was 28.1% (18/64 patients), and the prevalence was 15.2% (7/46) in the AL3 group and 61.1% (11/18) in the BL3 group, which was significantly different (P?<?0.05). CONCLUSIONS.: LIV would be selected at L3 (EV) when the curve is flexible; L3 crosses CSVL with a rotation of less than grade II in preoperative bending radiographs. However, if the curve is rigid, LIV should be extended to L4 (EV?+?1) in order to prevent the adding-on phenomenon in the treatment of major TL/L AIS using RD and DVR following PSI.Level of Evidence: 4
AB - STUDY DESIGN.: A retrospective comparative study. OBJECTIVE.: To analyze the exact distal fusion level in the treatment of major thoracolumbar and lumbar (TL/L) adolescent idiopathic scoliosis (AIS) using rod derotation (RD) and direct vertebral rotation (DVR) following pedicle screw instrumentation (PSI). SUMMARY OF BACKGROUND DATA.: Proper determination of distal fusion level is a very important factor in deformity correction and preservation of motion segments in the treatment of major TL/L AIS. METHODS.: AIS patients with major TL/L curves (n?=?64) treated by PSI with RD and DVR methods with a minimum 2-year follow-up were divided into AL3 (flexible) and BL3 (rigid) according to the flexibility and rotation by preoperative bending radiographs. RESULTS.: There was no significant difference in TL/L (major) curve between the AL3 and BL3 groups postoperatively (P?=?0.933) and at the last follow-up (P?=?0.144). Additionally, there was no significant difference in thoracic (minor) and compensatory (caudal) curve postoperatively (thoracic curve: P?=?0.828, compensatory curve: P?=?0.976); however, there was a significant difference in compensatory (caudal) curve at the last follow-up (P?=?0.041). The overall prevalence of unsatisfactory results was 28.1% (18/64 patients), and the prevalence was 15.2% (7/46) in the AL3 group and 61.1% (11/18) in the BL3 group, which was significantly different (P?<?0.05). CONCLUSIONS.: LIV would be selected at L3 (EV) when the curve is flexible; L3 crosses CSVL with a rotation of less than grade II in preoperative bending radiographs. However, if the curve is rigid, LIV should be extended to L4 (EV?+?1) in order to prevent the adding-on phenomenon in the treatment of major TL/L AIS using RD and DVR following PSI.Level of Evidence: 4
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U2 - 10.1097/BRS.0000000000001998
DO - 10.1097/BRS.0000000000001998
M3 - Article
C2 - 27879572
AN - SCOPUS:84996841889
JO - Spine
JF - Spine
SN - 0362-2436
ER -