Hui Liu1, Zihao Li1, Babur Helil1, Jianru Wang1, Huafeng Wang2, Taiping Wang3, Zemin Li1, Hua Wang1, Haowen Cui1, Haitao Wang1, Zhaomin Zheng4. 1. Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-Sen University; Guangdong Province Key Laboratory of Orthopaedics and Traumatology, 58 Zhongshan 2nd Road, Guangzhou, 510080, China. 2. Department of Spine Surgery, Fuzhou Second People's Hospital, 47 Shangteng Road, Fuzhou, 350007, China. 3. Department of Spine Surgery, Chengdu Third People's Hospital, 82 Qinglong Road, Chengdu, 610000, China. 4. Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-Sen University; Guangdong Province Key Laboratory of Orthopaedics and Traumatology, 58 Zhongshan 2nd Road, Guangzhou, 510080, China. zhzhaom@mail.sysu.edu.cn.
Abstract
PURPOSE: To analyze the correlation between immediate postoperative coronal imbalance and the matching degree of the correction rates of the main curve and compensatory curves in the surgical treatment of severe adult idiopathic scoliosis. METHODS: Patients were categorized into three types based on the preoperative coronal balance status (type A = balance, type B = shifted to cave side and type C = shifted to convex side), and each type was further divided into two subgroups based on the postoperative coronal balance status (balance and imbalance). Different coronal parameters before and after operations were calculated and compared. RESULTS: The rate of postoperative CIB was highest in type C patients (53.8%) and lowest in type A patients (31.5%). To avoid postoperative CIB, the value of the postoperative CRmain should fall within the range of 1.001 × CRcomp ± 2.84% in type A patients, 1.112 × CRcomp + 3.3% ± 5.02% in type B patients and 0.907 × CRcomp - 2.5% ± 4.38% in type C patients. CONCLUSION: Mismatch between the correction rates of the main curve and compensation curves is a critical cause of immediate postoperative CIB. The relatively equal correction of the main curve and compensatory curves is essential for type A patients to achieve postoperative coronal balance, while the correction rate of the main curve should be higher than the compensatory curves in type B patients and vice versa in type C patients. Three formulas for the three different types were developed to provide helpful guidance information for surgical planning.
PURPOSE: To analyze the correlation between immediate postoperative coronal imbalance and the matching degree of the correction rates of the main curve and compensatory curves in the surgical treatment of severe adult idiopathic scoliosis. METHODS:Patients were categorized into three types based on the preoperative coronal balance status (type A = balance, type B = shifted to cave side and type C = shifted to convex side), and each type was further divided into two subgroups based on the postoperative coronal balance status (balance and imbalance). Different coronal parameters before and after operations were calculated and compared. RESULTS: The rate of postoperative CIB was highest in type C patients (53.8%) and lowest in type A patients (31.5%). To avoid postoperative CIB, the value of the postoperative CRmain should fall within the range of 1.001 × CRcomp ± 2.84% in type A patients, 1.112 × CRcomp + 3.3% ± 5.02% in type B patients and 0.907 × CRcomp - 2.5% ± 4.38% in type C patients. CONCLUSION: Mismatch between the correction rates of the main curve and compensation curves is a critical cause of immediate postoperative CIB. The relatively equal correction of the main curve and compensatory curves is essential for type A patients to achieve postoperative coronal balance, while the correction rate of the main curve should be higher than the compensatory curves in type B patients and vice versa in type C patients. Three formulas for the three different types were developed to provide helpful guidance information for surgical planning.
Authors: Daniel J Miller; Omar Jameel; Hiroko Matsumoto; Joshua E Hyman; Frank J Schwab; David P Roye; Michael G Vitale Journal: Stud Health Technol Inform Date: 2010