Document Detail

Factors affecting distal end & global decompensation in coronal/sagittal planes 2 years after fusion.
MedLine Citation:
PMID:  20543414     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Decompensation of un-fused vertebrae is a potential complication of spinal instrumentation performed for adolescent idiopathic scoliosis (AIS). This can result in problems requiring revision surgery. The purpose of this study was to compare patients who decompensated in the sagittal/coronal plane and those who do not and to identify risk factors. METHODS: The Spinal Deformity Study Group data-base for AIS identified 908 patients at 2 years post-op. Coronal measures analyzed included coronal balance (CB), coronal position of the lower instrumented vertebra (CPL) and LIV tilt angle (LTA). Sagittal measures included sagittal balance (SB) and distal-junctional kyphosis (DJK). The incidence of decompensation at 2 years was: CB-16.83%, LTA-37.53%, CPL-21.17%, negative SB-51.88%, positive SB-7.62%, DJK-6.8%. Decompensated patients were compared to those who were not using preoperative, and 4-16 weeks post-op values. RESULTS: Numerous significant differences were found between patients who decompensated at 2 years and those who did not. CB was significantly influenced by larger height/weight, increased Cobb, preexisting CB and a thoracic LIV. In addition to other factors LTA decompensation was more likely to occur in JIS. CPL was associated with pelvic-obliquity and thoracic LIV. Post-operative sagittal balance could be predicted by pre-operative sagittal balance. DJK was also associated with larger weight and preoperative sagittal measures. DISCUSSION AND CONCLUSION: Less correction in sagittal/coronal planes is a risk factor for decompensation. Curve correction was significant in predicting coronal decompensation. Failure to control sagittal alignment was a risk factor in sagittal decompensation.
Daniel J Miller; Omar Jameel; Hiroko Matsumoto; Joshua E Hyman; Frank J Schwab; David P Roye; Michael G Vitale
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Studies in health technology and informatics     Volume:  158     ISSN:  0926-9630     ISO Abbreviation:  Stud Health Technol Inform     Publication Date:  2010  
Date Detail:
Created Date:  2010-06-14     Completed Date:  2010-09-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9214582     Medline TA:  Stud Health Technol Inform     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  141-6     Citation Subset:  T    
Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY, USA.
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MeSH Terms
Databases, Factual
Scoliosis / surgery
Spinal Fusion / rehabilitation*
Thoracic Vertebrae / surgery*
Treatment Outcome

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