Mohsen Karami1, Arash Maleki1, Keyvan Mazda1. 1. Department of Orthopedic Surgery, Taleghani Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Abstract
BACKGROUND: To determine the most important preoperative factors that affect postoperative coronal parameters of scoliotic curves. METHODS: All Adolescent Idiopathic Scoliosis (AIS) patients included in the study were classified according to Lenke and King Classification. The fusion levels were selected according to the rigidity of the existing curves (correction less than 50%), tilt of T1 and shoulders, sagittal angle of the curves and with considering stable and neutral end vertebra. The radiographic coronal parameters: shoulders tilt angle, iliolumbar angle and coronal balance were measured in all patients before, after, and in the last follow-up visit. RESULTS: One hundred twenty patients after mean of 25 months follow-up (18-40 months) were included in the study. Before operation, abnormal coronal balance (more than 2 cm shift) was noticed in 46 patents (38%) and in the last visit, was noted in 22 patients (18%). Multivariate regression analysis revealed a significant predictive value of the preoperative coronal balance on the last visit coronal balance (P value=0.01). CONCLUSION: Preoperative coronal balance is very important to make a balanced spine after surgery. Other parameters like Lenke classification or main thoracic overcorrection did not affect postoperative coronal decompensation.
BACKGROUND: To determine the most important preoperative factors that affect postoperative coronal parameters of scoliotic curves. METHODS: All Adolescent Idiopathic Scoliosis (AIS) patients included in the study were classified according to Lenke and King Classification. The fusion levels were selected according to the rigidity of the existing curves (correction less than 50%), tilt of T1 and shoulders, sagittal angle of the curves and with considering stable and neutral end vertebra. The radiographic coronal parameters: shoulders tilt angle, iliolumbar angle and coronal balance were measured in all patients before, after, and in the last follow-up visit. RESULTS: One hundred twenty patients after mean of 25 months follow-up (18-40 months) were included in the study. Before operation, abnormal coronal balance (more than 2 cm shift) was noticed in 46 patents (38%) and in the last visit, was noted in 22 patients (18%). Multivariate regression analysis revealed a significant predictive value of the preoperative coronal balance on the last visit coronal balance (P value=0.01). CONCLUSION: Preoperative coronal balance is very important to make a balanced spine after surgery. Other parameters like Lenke classification or main thoracic overcorrection did not affect postoperative coronal decompensation.