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Background: The X-ray films of the patients with Marfan syndrome scoliosis (MSS) look like those with adolescent idiopathic scoliosis (AIS). In literature, there are many reports on the correction results of AIS, while there are a few studies focused on the difference of the correction results between MSS and AIS. This study aims to analyze whether there are differences of posterior correction surgery in MSS and AIS. Methods: All the patients included underwent posterior correction surgery. The radiographic data, operation duration, estimated blood loss, transfusion, fusion levels, and correction rate were retrospectively reviewed and analyzed between the two groups. Results: Group MSS included 42 patients, 11 male and 31 female, with an average age of 15.2 years old. Group AIS included 168 patients (ratio, 1:4), 34 male and 134 female, with an average age of 14.5 years old. Twenty-three patients in group MSS and 94 patients in group AIS were followed up regularly, with an average time of 18.4 and 18.5 months, respectively. The mean coronal Cobb angle of the major curve before operation and at final follow-up, the correction rate, fusion level, operation duration, estimated blood loss during operation, and transfusion between the two groups were 60.4 and 57.5°, 14.6 and 15.2°, 76.4 and 74.1 %, 11.5 and 11.0 vertebrae, 4.6 and 4.0 h, 845 and 698 ml, and 1151 and 894 ml, respectively. The age, gender ratio, curve type, and coronal Cobb angle of the major curve were all matched (all P > 0.05). Group MSS had a longer operation duration and more estimated blood loss compared with those of group AIS (both P < 0.05), while there was no significant difference in terms of fusion level, transfusion, coronal Cobb angle of the major curve at final follow-up, and the correction rate (all P > 0.05). Conclusions: When performing posterior correction for scoliosis, the surgeons should be aware that the patients with Marfan syndrome scoliosis had more estimated blood loss and longer operation duration than AIS patients, while the correction rate was similar. [ABSTRACT FROM AUTHOR]

Background: The patients with extremely severe spinal deformity are commonly considered high-risk candidates for surgical treatment because of their underlying lung disease. Currently, little has been reported about the postoperative pulmonary complication events in this population. This retrospective study sought to evaluate preoperative pulmonary function tests in the surgical treatment of extremely severe scoliosis. Methods: Preoperative forced vital capacity (FVC), FVC ratio, forced expiratory volume at the end of the first second (FEV1), FEV1 ratio, peak expiratory flow (PEF), and PEF ratio were performed and evaluated on 60 patients with extremely severe scoliosis (coronary main Cobb angle ≥100°). Results: Among the 60 patients, 11 (18.3%), 13 (21.7%), and 22 (36.7%) had severe, moderate, and mild pulmonary dysfunction, respectively. Compared with the moderate and mild scoliosis groups, significant differences were observed in Cobb, FVC, FVC ratio, FEV1, FEV1 ratio, and PEF ratio in the extremely severe scoliosis group. Various postoperative pulmonary complications occurred in nine cases (15%). Patients with severe or moderate dysfunction as measured by the FVC ratio had a higher incidence of postoperative pulmonary complications. A transthoracic procedure was not related to postoperative pulmonary complications, but thoracoplasty significantly increased the incidence of postoperative pulmonary complications (P < 0.001, OR = 20, 95% CI = 3.45–115.97). Discussion: Pulmonary function was impaired in extremely severe scoliosis. Patients with severe restrictive pulmonary dysfunction had a higher incidence of postoperative pulmonary complications. Thoracoplasty was an important risk factor in the prediction of postoperative pulmonary complications. [ABSTRACT FROM AUTHOR]

Background: In idiopathic scoliosis patients, after anterior spinal fusion and instrumentation, the discs (interspace angle) between the lowest instrumented vertebra (LIV) and the next caudal vertebra became more wedged. We reviewed these patients and analyzed the changes of the angle. Methods: By reviewing the medical records and roentgenograms of adolescent idiopathic scoliosis patients underwent anterior spinal fusion and instrumentation, Cobb angle of the curve, correction rate, coronal balance, LIV rotation, interspace angle were measured and analyzed. Results: There were total 30 patients included. The mean coronal Cobb angle of the main curve (thoracolumbar/lumbar curve) before and after surgery were 48.9° and 11.7°, respectively, with an average correction rate of 76.1%. The average rotation of LIV before surgery was 2.1 degree, and was improved to 1.2 degree after surgery. The interspace angle before surgery, on convex side-bending films, after surgery, at final follow up were 3.2°, -2.3°, 1.8° and 4.9°, respectively. The difference between the interspace angle after surgery and that preoperatively was not significant (P = 0.261), while the interspace angle at final follow-up became larger than that after surgery, and the difference was significant(P = 0.012). The interspace angle after surgery was correlated with that on convex side-bending films (r = 0.418, P = 0.022), and the interspace angle at final follow-up was correlated with that after surgery (r = 0.625, P = 0.000). There was significant correlation between the loss of the interspace angle and the loss of coronal Cobb angle of the main curve during follow-up (r = 0.483, P = 0.007). Conclusion: The interspace angle could be improved after anterior correction and instrumentation surgery, but it became larger during follow-up. The loss of the interspace angle was correlated with the loss of coronal Cobb angle of the main curve during follow-up. [ABSTRACT FROM AUTHOR]