ShengFei Zhang1,2, Liang Zhang2, XinMin Feng2, HuiLin Yang3. 1. Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou, 215006, People's Republic of China. 2. Department of Orthopaedics, Northern Jiangsu People's Hospital, Yangzhou, 225001, People's Republic of China. 3. Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou, 215006, People's Republic of China. hlyangspine@163.com.
Abstract
PURPOSE: This is the first systematic review and meta-analysis to detect the incidence and risk factors for postoperative shoulder imbalance (PSI) in scoliosis. METHODS: A systematic online search was conducted to identify eligible studies. ES, OR and WMD with 95% CI were used to assess the incidence and risk factors associated with PSI. RESULTS: Twenty-six studies were recruited. The pooled incidence of PSI was 25% (95% CI 20-31%). The incidence in Lenke 1 AIS, Lenke 2 AIS, Lenke 5 AIS and mixed AIS was 20% (9-31%), 26% (15-37%), 31% (17-45%) and 27% (19-35%), respectively. Using RSH ≥10 mm as the criterion of PSI, we found that preoperative LC, postoperative RSH, correction rate of MTC at follow-up were primary risk factors for PSI at follow-up. In the analysis of using RSH ≥20 mm as the criterion of PSI, our results showed that Risser sign, postoperative RSH, correction rate of PTC at follow-up, and LC at follow-up were contributing to PSI. Besides, scoliosis patients with PSI were more likely to suffer from adding-on. CONCLUSIONS: The pooled incidence of PSI in scoliosis was 25%. Risser sign, preoperative LC, postoperative RSH, correction rate of PTC at follow-up, correction rate of MTC at follow-up, and LC at follow-up were risk factors for PSI in patients with scoliosis. Adding-on might be a compensatory mechanism for PSI. It is recommended that (1) sufficient correction of PTC and moderate correction of MTC and LC in the operation should be performed; (2) PSI should be prevented not only for the patients' postoperative appearance, but also for preventing the adding-on phenomenon.
PURPOSE: This is the first systematic review and meta-analysis to detect the incidence and risk factors for postoperative shoulder imbalance (PSI) in scoliosis. METHODS: A systematic online search was conducted to identify eligible studies. ES, OR and WMD with 95% CI were used to assess the incidence and risk factors associated with PSI. RESULTS: Twenty-six studies were recruited. The pooled incidence of PSI was 25% (95% CI 20-31%). The incidence in Lenke 1 AIS, Lenke 2 AIS, Lenke 5 AIS and mixed AIS was 20% (9-31%), 26% (15-37%), 31% (17-45%) and 27% (19-35%), respectively. Using RSH ≥10 mm as the criterion of PSI, we found that preoperative LC, postoperative RSH, correction rate of MTC at follow-up were primary risk factors for PSI at follow-up. In the analysis of using RSH ≥20 mm as the criterion of PSI, our results showed that Risser sign, postoperative RSH, correction rate of PTC at follow-up, and LC at follow-up were contributing to PSI. Besides, scoliosispatients with PSI were more likely to suffer from adding-on. CONCLUSIONS: The pooled incidence of PSI in scoliosis was 25%. Risser sign, preoperative LC, postoperative RSH, correction rate of PTC at follow-up, correction rate of MTC at follow-up, and LC at follow-up were risk factors for PSI in patients with scoliosis. Adding-on might be a compensatory mechanism for PSI. It is recommended that (1) sufficient correction of PTC and moderate correction of MTC and LC in the operation should be performed; (2) PSI should be prevented not only for the patients' postoperative appearance, but also for preventing the adding-on phenomenon.
Authors: T R Kuklo; L G Lenke; D S Won; E J Graham; F A Sweet; R R Betz; K H Bridwell; K M Blanke Journal: Spine (Phila Pa 1976) Date: 2001-09-15 Impact factor: 3.468
Authors: Joshua T Bram; Nishank Mehta; John M Flynn; Jason B Anari; Keith D Baldwin; Burt Yaszay; Joshua M Pahys; Patrick J Cahill Journal: Spine Deform Date: 2020-11-17