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Radiographical Results of Adolescent Idiopathic Scoliosis with Major Curve at Proximal Thoracic Spine – Lumbar Fusion

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A study published in the journal Spine Surg Relat Res investigated the radiographic characteristics of adolescent idiopathic scoliosis (AIS) with a major curve at the proximal thoracic (PT) area before and after correction surgery. The study included twelve patients who underwent posterior correction and fusion surgery using pedicle screw constructs. The patients were categorized into a double-curve (DC) type or a single-curve (SC) type. The results showed favorable correction rates for the PT curve in both groups, but the Cobb angle of the lumbar curve improved in the DC group and deteriorated in the SC group after surgery. The study highlights the importance of considering the fusion area, especially the LIV, when operating on the SC curve type

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : innovative day surgery spinal centre in UK

Published article

CONCLUSIONS: We illustrated the postoperative radiographical changes of 12 consecutive patients with the major curve at the PT curve. Although posterior correction and fusion surgery corrected the PT curve satisfactorily in both DC and SC patients, the Cobb angle of the lumbar curve deteriorated after surgery in all SC patients. Surgeons need to pay attention to the fusion area, especially LIV, when operating the SC curve type.

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Spine Surg Relat Res. 2023 Mar 13;7(4):371-376. doi: 10.22603/ssrr.2022-0088. eCollection 2023 Jul 27.ABSTRACTINTRODUCTION: Adolescent idiopathic scoliosis (AIS) with a major curve at the main thoracic (MT) area is classified as Lenke type 1, 2, or 3 depending on the flexibility of the proximal thoracic (PT) curve and lumbar curve. No definite classification has been established,

Spine Surg Relat Res. 2023 Mar 13;7(4):371-376. doi: 10.22603/ssrr.2022-0088. eCollection 2023 Jul 27.

ABSTRACT

INTRODUCTION: Adolescent idiopathic scoliosis (AIS) with a major curve at the main thoracic (MT) area is classified as Lenke type 1, 2, or 3 depending on the flexibility of the proximal thoracic (PT) curve and lumbar curve. No definite classification has been established for a major curve at the PT spine. The purpose of this study is to investigate the radiographic characteristics before and after correction surgery for AIS with a major curve at the PT area.

METHODS: This is a retrospective cohort study at a single academic institution. Twelve patients with a major curve at the PT spine participated in our study and followed for at least two years after surgery. We evaluated the pre- and postoperative Cobb angles of the curve, curve range, location of the apex, sagittal parameters, and shoulder balance-related parameters. All patients were treated by posterior correction and fusion surgery using pedicle screw constructs.

RESULTS: The patients were classified as having a double-curve (DC) type, in which the MT curve was structural, or a single-curve (SC) type, in which the MT curve was corrected to less than 25° on supine side-bending films. The mean correction rates for the PT curve were favorable in both groups (DC, 65.7%±9.6%; SC, 39.2%±4.9%). The mean Cobb angle of the lumbar curve improved in the DC group (preoperative, 17.1°±4.0°; postoperative, 5.0°±4.2°) but deteriorated in the SC group (preoperative, 7.1°±1.2°; postoperative, 12.4°±4.4°) after surgery.

CONCLUSIONS: We illustrated the postoperative radiographical changes of 12 consecutive patients with the major curve at the PT curve. Although posterior correction and fusion surgery corrected the PT curve satisfactorily in both DC and SC patients, the Cobb angle of the lumbar curve deteriorated after surgery in all SC patients. Surgeons need to pay attention to the fusion area, especially LIV, when operating the SC curve type.

PMID:37636137 | PMC:PMC10447189 | DOI:10.22603/ssrr.2022-0088

The London Spine Unit : innovative day surgery spinal centre in UK

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Radiographical Results of Adolescent Idiopathic Scoliosis with Major Curve at Proximal Thoracic Spine

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Spine Surg Relat Res. 2023 Mar 13;7(4):371-376. doi: 10.22603/ssrr.2022-0088. eCollection 2023 Jul 27.ABSTRACTINTRODUCTION: Adolescent idiopathic scoliosis (AIS) with a major curve at the main thoracic (MT) area is classified as Lenke type 1, 2, or 3 depending on the flexibility of the proximal thoracic (PT) curve and lumbar curve. No definite classification has been established

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