| Lumbar curve response to selective thoracic fusion in adult idiopathic scoliosis. | |
| | |
MedLine Citation:
|
PMID: 18261962 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND CONTEXT: To date, no study has critically examined the radiographic characteristics of the lumbar curve after selective thoracic fusion for the adult idiopathic scoliosis patient population. PURPOSE: To evaluate the radiographic response of the lumbar curve to selective thoracic fusion in the adult scoliosis population with correlative clinical outcomes. STUDY DESIGN: Retrospective case series. PATIENT SAMPLE: Thirty patients with idiopathic scoliosis surgically treated at a mean age of 40 years (range, 20-66) using a posterior translational technique. OUTCOME MEASURES: Radiographic review and functional outcome assessment. METHODS: A retrospective, minimum 2-year follow-up, radiographic, and clinical review. All patients underwent selective thoracic posterior fusion with end-instrumented vertebra at T11 (1), T12 (7), L1 (14), and L2 (8). RESULTS: At a mean follow-up of 39 (range, 24-87) months, spontaneous lumbar curve Cobb improvement (36 degrees -18 degrees = 50% correction) was less than the bending radiograph (12 degrees , 68% correction). Lowest-instrumented vertebra (LIV) tilt angle improved from 24 to 9 degrees and LIV disc angle improved from 8 to 4 degrees (p < .001). Lumbar apical disc angle improved from 10 to 7 degrees (p < .001). Lumbar apical vertebral translation remained unchanged from pre-op (17 mm) to latest follow-up (17 mm) (p = .23). Lumbar curve rotation increased from 8 to 10 degrees (p = .11). One patient had coronal imbalance of greater than 3 cm and two patients had greater than 3 cm of negative sagittal imbalance. Mean subgroup scores of the Scoliosis Research Society-22 questionnaire improved (p < .01) for pain (3.0-3.8) and self-image (2.5-4.0) but remained the same for function and mental health. Only one patient required extension of fusion to include the lumbar curve 6 years postoperatively. CONCLUSIONS: The lumbar curve response in adult, selective thoracic scoliosis surgery is characterized by 1) moderate correction but less than the bending film Cobb; 2) greater change in LIV tilt and disc angle than apical vertebra disc angle; 3) no change in lumbar apical translation or rotation; 4) more significant disc height preservation at the LIV compared with lumbar apex. Good clinical outcomes can be achieved with posterior translational instrumentation in adult scoliosis patients. |
| | |
Authors:
|
Michael W Peelle; Oheneba Boachie-Adjei; Gina Charles; Yamuna Kanazawa; Addisu Mesfin |
Publication Detail:
|
Type: Journal Article Date: 2008-02-08 |
Journal Detail:
|
Title: The spine journal : official journal of the North American Spine Society Volume: 8 ISSN: 1529-9430 ISO Abbreviation: Spine J Publication Date: 2008 Nov-Dec |
Date Detail:
|
Created Date: 2008-11-05 Completed Date: 2009-02-17 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 101130732 Medline TA: Spine J Country: United States |
Other Details:
|
Languages: eng Pagination: 897-903 Citation Subset: IM |
Affiliation:
|
Wright-Patterson AFB, Dayton, OH 45433, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Female Follow-Up Studies Humans Lumbar Vertebrae / radiography, surgery* Male Middle Aged Postoperative Complications Retrospective Studies Scoliosis / radiography, surgery* Spinal Fusion / methods* Thoracic Vertebrae / radiography, surgery* Treatment Outcome Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Depressed mood over time after open heart surgery impacts patient well-being: a combined study.
Next Document: Choice of plate may affect outcomes for single versus multilevel ACDF: results of a prospective rand...