Document Detail


[Anterior endoscopic release/posterior spinal instrumentation for severe and rigid thoracic adolescent idiopathic scoliosis].
MedLine Citation:
PMID:  22333445     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVES: To compare the results of spinal correction for severe and rigid thoracic adolescent idiopathic scoliosis (T-AIS) by combined anterior endoscopic release/posterior hybrid constructs of proximal hooks and distal pedicle screws spinal fusion (APSF) and an all-pedicle screw construct posterior-only spinal fusion (PSSF).
METHODS: T-AIS patients with curves ≥ 70° and flexibility ≤ 50% who underwent APSF from November 2001 to December 2008 were retrospectively reviewed (APSF group). In addition, the patients treated by PSSF with comparable curve severity and flexibility were selected as control (PSSF group). All patients had a minimum 2-year follow-up. The thoracic curve and kyphosis were measured on standing long-cassette posteroanterior and lateral radiographs of entire spine taken at pre-operation, post-operation and last follow-up. The radiographic parameters, fusion levels, implant density and complications were compared between two groups.
RESULTS: There were 18 patients treated with APSF and 27 with PSSF, with mean age of (15.9 ± 2.1) years and (15.8 ± 2.9) years, respectively. In patients treated with APSF, the mean thoracic curve was 87° ± 12° with 58% ± 13% correction after operation; while in those treated with PSSF, the mean thoracic curve was 79° ± 8° with 59% ± 8% correction after operation. The number of levels fused was 12.7 ± 1.2 and 12.8 ± 1.4, while the implant density was 48% ± 5% and 61% ± 6% in APSF group and PSSF group, respectively. Patients treated with APSF and PSSF were followed by (4.5 ± 0.6) years and (2.8 ± 0.7) years, with a mean loss of correction of 4.4° and 1.9° at final follow-up. Despite the significant higher implant density found in PSSF (t = 6.123, P < 0.001), there were no statistically significant differences between the groups for gender, age, number of levels fused, preoperative coronal/sagittal Cobb measurements, coronal curve flexibility, or amount of postoperative coronal Cobb correction.
CONCLUSIONS: In patients with severe and rigid T-AIS, PSSF could achieve same curve correction as an APSF by increasing implant density. In treating scoliosis patients with high risk of having loss of curve correction, implant complications or pseudarthrosis, APSF is recommended to achieve solid spinal fusion.
Authors:
Yong Qiu; Wei-Jun Wang; Feng Zhu; Ze-Zhang Zhu; Bin Wang; Yang Yu
Publication Detail:
Type:  English Abstract; Journal Article    
Journal Detail:
Title:  Zhonghua wai ke za zhi [Chinese journal of surgery]     Volume:  49     ISSN:  0529-5815     ISO Abbreviation:  Zhonghua Wai Ke Za Zhi     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2012-02-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0153611     Medline TA:  Zhonghua Wai Ke Za Zhi     Country:  China    
Other Details:
Languages:  chi     Pagination:  1071-5     Citation Subset:  IM    
Affiliation:
Department of Spine Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China. Email: scoliosis2002@sina.com.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  [A feasibility research of unilateral incision minimally invasive transforaminal lumbar interbody fu...
Next Document:  [Clinical study on lumbar spondylolisthesis treated by minimally invasive transforaminal lumbar inte...