Risk factors for coronal decompensation after posterior spinal instrumentation and fusion in adolescent idiopathic scoliosis

Jaime A. Gomez, Hiroko Matsumoto, Nicholas D. Colacchio, David P. Roye, Daniel J. Sucato, B. Stephens Richards, John B. Emans, Mark A. Erickson, James O. Sanders, Lawrence G. Lenke, Michael G. Vitale

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Study Design Retrospective review of multicenter data set with adolescent idiopathic scoliosis (AIS) patients with at least 2 years of follow-up after posterior spinal instrumentation and fusion (PSIF). Objectives The purpose of this study is to investigate risk factors for coronal decompensation 2 years after PSIF for AIS. Summary of Background Data Coronal decompensation is a potential complication of spinal instrumentation for AIS. This can result in problems requiring revision surgery. Methods Demographic, clinical, and radiographic measures were reviewed on 890 identified patients. Coronal decompensation was defined as a change farther away from midline from 6 weeks postoperatively to 2 years in any one of the following radiographic parameters: change in coronal balance >2 cm; change in coronal position of the lowest instrumented vertebra (LIV) >2 cm; change in thoracic trunk shift >2 cm; or change in LIV tilt angle >10°. Patients with decompensation were compared to those without. The relationship between the LIV and lowest end vertebra (LEV) was examined as an independent variable. Results Two years postoperation, 6.4% (57/890) of patients exhibited coronal decompensation. Multivariate regression revealed that decompensated patients were twice as likely to be male, have lower preoperative Risser score, and lower percentage major curve correction. The relationship between the LIV and LEV as well as quality of life surveys were not significantly different between decompensated and nondecompensated patients at 2 years. Conclusions Two years after PSIF, 6.4% of patients with AIS exhibit radiographic coronal decompensation. Although this study did not demonstrate a significant association between the relationship of LIV and LEV and decompensation 2 years postoperation, results of this study indicate that skeletal immaturity, male gender, and less correction of the major curve may be related to higher rates of coronal decompensation.

Original languageEnglish (US)
Pages (from-to)380-385
Number of pages6
JournalSpine Deformity
Volume2
Issue number5
DOIs
StatePublished - 2014
Externally publishedYes

Fingerprint

Spinal Fusion
Scoliosis
Spine
Reoperation
Thorax
Retrospective Studies
Quality of Life
Demography

Keywords

  • Adolescent idiopathic scoliosis
  • Coronal balance
  • Decompensation
  • Posterior spinal instrumentation and fusion

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Risk factors for coronal decompensation after posterior spinal instrumentation and fusion in adolescent idiopathic scoliosis. / Gomez, Jaime A.; Matsumoto, Hiroko; Colacchio, Nicholas D.; Roye, David P.; Sucato, Daniel J.; Richards, B. Stephens; Emans, John B.; Erickson, Mark A.; Sanders, James O.; Lenke, Lawrence G.; Vitale, Michael G.

In: Spine Deformity, Vol. 2, No. 5, 2014, p. 380-385.

Research output: Contribution to journalArticle

Gomez, JA, Matsumoto, H, Colacchio, ND, Roye, DP, Sucato, DJ, Richards, BS, Emans, JB, Erickson, MA, Sanders, JO, Lenke, LG & Vitale, MG 2014, 'Risk factors for coronal decompensation after posterior spinal instrumentation and fusion in adolescent idiopathic scoliosis', Spine Deformity, vol. 2, no. 5, pp. 380-385. https://doi.org/10.1016/j.jspd.2014.05.001
Gomez, Jaime A. ; Matsumoto, Hiroko ; Colacchio, Nicholas D. ; Roye, David P. ; Sucato, Daniel J. ; Richards, B. Stephens ; Emans, John B. ; Erickson, Mark A. ; Sanders, James O. ; Lenke, Lawrence G. ; Vitale, Michael G. / Risk factors for coronal decompensation after posterior spinal instrumentation and fusion in adolescent idiopathic scoliosis. In: Spine Deformity. 2014 ; Vol. 2, No. 5. pp. 380-385.
@article{6daf2363c4e74283898d8157655a091f,
title = "Risk factors for coronal decompensation after posterior spinal instrumentation and fusion in adolescent idiopathic scoliosis",
abstract = "Study Design Retrospective review of multicenter data set with adolescent idiopathic scoliosis (AIS) patients with at least 2 years of follow-up after posterior spinal instrumentation and fusion (PSIF). Objectives The purpose of this study is to investigate risk factors for coronal decompensation 2 years after PSIF for AIS. Summary of Background Data Coronal decompensation is a potential complication of spinal instrumentation for AIS. This can result in problems requiring revision surgery. Methods Demographic, clinical, and radiographic measures were reviewed on 890 identified patients. Coronal decompensation was defined as a change farther away from midline from 6 weeks postoperatively to 2 years in any one of the following radiographic parameters: change in coronal balance >2 cm; change in coronal position of the lowest instrumented vertebra (LIV) >2 cm; change in thoracic trunk shift >2 cm; or change in LIV tilt angle >10°. Patients with decompensation were compared to those without. The relationship between the LIV and lowest end vertebra (LEV) was examined as an independent variable. Results Two years postoperation, 6.4{\%} (57/890) of patients exhibited coronal decompensation. Multivariate regression revealed that decompensated patients were twice as likely to be male, have lower preoperative Risser score, and lower percentage major curve correction. The relationship between the LIV and LEV as well as quality of life surveys were not significantly different between decompensated and nondecompensated patients at 2 years. Conclusions Two years after PSIF, 6.4{\%} of patients with AIS exhibit radiographic coronal decompensation. Although this study did not demonstrate a significant association between the relationship of LIV and LEV and decompensation 2 years postoperation, results of this study indicate that skeletal immaturity, male gender, and less correction of the major curve may be related to higher rates of coronal decompensation.",
keywords = "Adolescent idiopathic scoliosis, Coronal balance, Decompensation, Posterior spinal instrumentation and fusion",
author = "Gomez, {Jaime A.} and Hiroko Matsumoto and Colacchio, {Nicholas D.} and Roye, {David P.} and Sucato, {Daniel J.} and Richards, {B. Stephens} and Emans, {John B.} and Erickson, {Mark A.} and Sanders, {James O.} and Lenke, {Lawrence G.} and Vitale, {Michael G.}",
year = "2014",
doi = "10.1016/j.jspd.2014.05.001",
language = "English (US)",
volume = "2",
pages = "380--385",
journal = "Spine Deformity",
issn = "2212-134X",
publisher = "Elsevier BV",
number = "5",

}

TY - JOUR

T1 - Risk factors for coronal decompensation after posterior spinal instrumentation and fusion in adolescent idiopathic scoliosis

AU - Gomez, Jaime A.

AU - Matsumoto, Hiroko

AU - Colacchio, Nicholas D.

AU - Roye, David P.

AU - Sucato, Daniel J.

AU - Richards, B. Stephens

AU - Emans, John B.

AU - Erickson, Mark A.

AU - Sanders, James O.

AU - Lenke, Lawrence G.

AU - Vitale, Michael G.

PY - 2014

Y1 - 2014

N2 - Study Design Retrospective review of multicenter data set with adolescent idiopathic scoliosis (AIS) patients with at least 2 years of follow-up after posterior spinal instrumentation and fusion (PSIF). Objectives The purpose of this study is to investigate risk factors for coronal decompensation 2 years after PSIF for AIS. Summary of Background Data Coronal decompensation is a potential complication of spinal instrumentation for AIS. This can result in problems requiring revision surgery. Methods Demographic, clinical, and radiographic measures were reviewed on 890 identified patients. Coronal decompensation was defined as a change farther away from midline from 6 weeks postoperatively to 2 years in any one of the following radiographic parameters: change in coronal balance >2 cm; change in coronal position of the lowest instrumented vertebra (LIV) >2 cm; change in thoracic trunk shift >2 cm; or change in LIV tilt angle >10°. Patients with decompensation were compared to those without. The relationship between the LIV and lowest end vertebra (LEV) was examined as an independent variable. Results Two years postoperation, 6.4% (57/890) of patients exhibited coronal decompensation. Multivariate regression revealed that decompensated patients were twice as likely to be male, have lower preoperative Risser score, and lower percentage major curve correction. The relationship between the LIV and LEV as well as quality of life surveys were not significantly different between decompensated and nondecompensated patients at 2 years. Conclusions Two years after PSIF, 6.4% of patients with AIS exhibit radiographic coronal decompensation. Although this study did not demonstrate a significant association between the relationship of LIV and LEV and decompensation 2 years postoperation, results of this study indicate that skeletal immaturity, male gender, and less correction of the major curve may be related to higher rates of coronal decompensation.

AB - Study Design Retrospective review of multicenter data set with adolescent idiopathic scoliosis (AIS) patients with at least 2 years of follow-up after posterior spinal instrumentation and fusion (PSIF). Objectives The purpose of this study is to investigate risk factors for coronal decompensation 2 years after PSIF for AIS. Summary of Background Data Coronal decompensation is a potential complication of spinal instrumentation for AIS. This can result in problems requiring revision surgery. Methods Demographic, clinical, and radiographic measures were reviewed on 890 identified patients. Coronal decompensation was defined as a change farther away from midline from 6 weeks postoperatively to 2 years in any one of the following radiographic parameters: change in coronal balance >2 cm; change in coronal position of the lowest instrumented vertebra (LIV) >2 cm; change in thoracic trunk shift >2 cm; or change in LIV tilt angle >10°. Patients with decompensation were compared to those without. The relationship between the LIV and lowest end vertebra (LEV) was examined as an independent variable. Results Two years postoperation, 6.4% (57/890) of patients exhibited coronal decompensation. Multivariate regression revealed that decompensated patients were twice as likely to be male, have lower preoperative Risser score, and lower percentage major curve correction. The relationship between the LIV and LEV as well as quality of life surveys were not significantly different between decompensated and nondecompensated patients at 2 years. Conclusions Two years after PSIF, 6.4% of patients with AIS exhibit radiographic coronal decompensation. Although this study did not demonstrate a significant association between the relationship of LIV and LEV and decompensation 2 years postoperation, results of this study indicate that skeletal immaturity, male gender, and less correction of the major curve may be related to higher rates of coronal decompensation.

KW - Adolescent idiopathic scoliosis

KW - Coronal balance

KW - Decompensation

KW - Posterior spinal instrumentation and fusion

UR - http://www.scopus.com/inward/record.url?scp=84906831625&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84906831625&partnerID=8YFLogxK

U2 - 10.1016/j.jspd.2014.05.001

DO - 10.1016/j.jspd.2014.05.001

M3 - Article

AN - SCOPUS:84906831625

VL - 2

SP - 380

EP - 385

JO - Spine Deformity

JF - Spine Deformity

SN - 2212-134X

IS - 5

ER -