Xiexiang Shao1, Wenyuan Sui1, Yaolong Deng1, Jingfan Yang1, Jian Chen1, Junlin Yang2. 1. Spine Center, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 1665 Kongjiang Road, Shanghai, People's Republic of China. 2. Spine Center, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 1665 Kongjiang Road, Shanghai, People's Republic of China. yangjunlin@xinhuamed.com.cn.
Abstract
PURPOSE: To introduce and evaluate our lowest instrumented vertebra (LIV) selection criteria for Lenke type 5/6 adolescent idiopathic scoliosis (AIS) patients with de-rotation technique. METHODS: There were 53 eligible Lenke 5/6 AIS patients with minimum 2-year follow-up enrolled in current study. The LIV selection criteria were: (1) the first vertebra touching the central sacral vertical line (CSVL) or the most cephalad vertebra which can return to stable zone under lateral bending position; (2) vertebral rotation no more than grade II by Nash-Moe rotation evaluation; (3) the lowest instrumented vertebra disc angle (LIVDA) could be reversed on lateral bending position. Demographic data, operation data and radiographic data were obtained and analyzed. RESULTS: Both clinical evaluation and radiographic data showed satisfactory outcome. The thoracolumbar/lumbar curve was improved from 53.4 ± 11.0° preoperatively to 6.9 ± 2.6° at the final follow-up. Two patients (3.8%) with adding on and two patients (3.8%) with coronal decompensation were identified at the final follow-up. LIV translation, LIV tilt and LIV disc angle were gradually improved after operation. The preoperative LIV tilt was positively correlated with Cobb angle (p = 0.010) and AVT (p = 0.030) at the final follow-up, and preoperative LIVDA was positively correlated with Cobb angle (p = 0.033) at the final follow-up. CONCLUSION: In Lenke 5/6 scoliosis, the current LIV selection criteria with de-rotation technique contribute to satisfactory correction rate of 87.1% and minimal alignment complications of 7.6%. LIV could be spontaneously and progressively improved after operation. Preoperative LIV tilt and LIVDA could predict postoperative correction and coronal balance.
PURPOSE: To introduce and evaluate our lowest instrumented vertebra (LIV) selection criteria for Lenke type 5/6 adolescent idiopathic scoliosis (AIS) patients with de-rotation technique. METHODS: There were 53 eligible Lenke 5/6 AIS patients with minimum 2-year follow-up enrolled in current study. The LIV selection criteria were: (1) the first vertebra touching the central sacral vertical line (CSVL) or the most cephalad vertebra which can return to stable zone under lateral bending position; (2) vertebral rotation no more than grade II by Nash-Moe rotation evaluation; (3) the lowest instrumented vertebra disc angle (LIVDA) could be reversed on lateral bending position. Demographic data, operation data and radiographic data were obtained and analyzed. RESULTS: Both clinical evaluation and radiographic data showed satisfactory outcome. The thoracolumbar/lumbar curve was improved from 53.4 ± 11.0° preoperatively to 6.9 ± 2.6° at the final follow-up. Two patients (3.8%) with adding on and two patients (3.8%) with coronal decompensation were identified at the final follow-up. LIV translation, LIV tilt and LIV disc angle were gradually improved after operation. The preoperative LIV tilt was positively correlated with Cobb angle (p = 0.010) and AVT (p = 0.030) at the final follow-up, and preoperative LIVDA was positively correlated with Cobb angle (p = 0.033) at the final follow-up. CONCLUSION: In Lenke 5/6 scoliosis, the current LIV selection criteria with de-rotation technique contribute to satisfactory correction rate of 87.1% and minimal alignment complications of 7.6%. LIV could be spontaneously and progressively improved after operation. Preoperative LIV tilt and LIVDA could predict postoperative correction and coronal balance.
Authors: Lee Phillips; Burt Yaszay; Tracey P Bastrom; Suken A Shah; Baron S Lonner; Firoz Miyanji; Amer F Samdani; Stefan Parent; Jahangir Asghar; Patrick J Cahill; Peter O Newton Journal: Eur Spine J Date: 2019-04-12 Impact factor: 3.134
Authors: Baron S Lonner; Yuan Ren; Vidyadhar V Upasani; Michelle M Marks; Peter O Newton; Amer F Samdani; Karen Chen; Harry L Shufflebarger; Suken A Shah; Daniel R Lefton; Hussein Nasser; Colin T Dabrowski; Randal R Betz Journal: Spine Deform Date: 2018 Nov - Dec