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Long-Term Outcomes of Anterior Spinal Fusion for Treating Thoracic Adolescent Idiopathic Scoliosis Curves: Average 15-year Follow-up Analysis.
MedLine Citation:
PMID:  23169073     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
STRUCTURED ABSTRACT: Study Design: Retrospective review.Objective: To assess the long-term outcomes of anterior spinal fusion (ASF) for treating thoracic adolescent idiopathic scoliosis (AIS).Summary of Background Data: Although ASF is reported to provide good coronal and sagittal correction of the main thoracic (MT) AIS curves, the long-term outcomes of ASF is unknown.Methods: A consecutive series of 25 patients with Lenke 1 MT AIS were included. Outcome measures comprised radiographic measurements, pulmonary function, and Scoliosis Research Society outcome instrument (SRS-30) scores (preoperative SRS-30 scores were not documented). Postoperative surgical revisions and complications were recorded.Results: Twenty-five patients were followed-up for 12-18 years (average, 15.2 years). The average MT Cobb angle correction rate and the correction loss at the final follow-up were 56.7% and 9.2°, respectively. The average preoperative instrumented level of kyphosis was 8.3°, which significantly improved to 18.6° (p = 0.0003) at the final follow-up. The average percent-predicted forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were significantly decreased during long-term follow-up measurements (73% and 69%; p = 0.0004 and 0.0016, respectively). However, no patient had complaints related to pulmonary function. The average total SRS-30 score was 4.0. Implant breakage was not observed. All patients, except 1 who required revision surgery, demonstrated solid fusion. Late instrumentation-related bronchial problems were observed in 1 patient who required implant removal and bronchial tube repair 13 years after the initial surgery.Conclusion: Overall radiographic findings and patient outcome measures of ASF for Lenke 1 MT AIS were satisfactory at an average follow-up of 15 years. ASF provides significant sagittal correction of the main thoracic curve with long-term maintenance of sagittal profiles. Percent-predicted values of FVC and FEV1 were decreased in this cohort; however, no patient had complaints related to pulmonary function.
Authors:
Hideki Sudo; Manabu Ito; Kiyoshi Kaneda; Yasuhiro Shono; Masahiko Takahata; Kuniyoshi Abumi
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-19
Journal Detail:
Title:  Spine     Volume:  -     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1Department of Orthopaedic Surgery, Hokkaido University Hospital, Sapporo, Japan, North-15, West-7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan 2Hokushin Memorial Hospital, Sapporo, Japan, Kikusuimotomati 3-3, Sapporo, Hokkaido 003-0823, Japan 3Department of Orthopaedic Surgery, Hokkaido Social Insurance Hospital, Sapporo, Japan, Nakanoshima 1-8, Sapporo, Hokkaido 062-8618, Japan.
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