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2 results on '"Maximal correction"'

1. Radiographic evaluation of posterior selective thoracolumbar or lumbar fusion for moderate Lenke 5C curves.

Author

Zhang, Yanbin, Lin, Guanfeng, Zhang, Jianguo, Guo, Jianwei, Wang, Shengru, Yang, Yang, Shen, Jianxiong, and Wang, Yipeng

Subjects
*LUMBAR puncture, *RADIOGRAPHY, *MAXIMAL functions, *ADOLESCENT idiopathic scoliosis, *SURGERY, *LUMBAR vertebrae surgery, *BONE screws, *LUMBAR vertebrae, *REOPERATION, *SCOLIOSIS, *SPINAL fusion, *THORACIC vertebrae, *TREATMENT effectiveness, *RETROSPECTIVE studies
Abstract

Introduction: Posterior selective thoracolumbar or lumbar (TL/L) fusion with pedicle screw constructs for adolescent idiopathic scoliosis (AIS) has been studied in a few researches. However, few studies have discussed the indication for selective TL/L fusion and the behaviors of its adjacent disc angle. The present study aims to discuss the indication for posterior selective TL/L fusion and the behavior of the adjacent disc angle.Methods: 45 consecutive cases of AIS undergoing posterior selective TL/L fusion were retrospectively evaluated, with an average follow-up of 36 months. Radiographs were reviewed to determine the coronal curve magnitude and the sagittal alignment preoperatively, postoperatively and at final follow-up. Thoracic curves in groups A had a correction loss of more than 5°, while thoracic curves in group B had a correction loss of not more than 5°.Results: The coronal curve magnitude of the TL/L curve averaged 44° preoperatively and it was corrected to 6° immediately with a correction rate of 84.8 %. At final follow-up it was 9° with a correction loss of 3°. The minor thoracic curve was 26° preoperatively, and the convex side bending curve magnitude averaged 8° with a flexibility of 72.7 %. It was corrected to 13° immediately with a spontaneous correction of 48.5 %. At final follow-up it was 14° with a correction loss of 1°. UIVA decreased from 4° to 2° after surgery, and it was 2° at final follow-up. LIVA decreased from 7° to 4° after surgery, and it was 5° at final follow-up. Maximal correction of TL/L curves in group A is significantly less than that in group B. 1 patient received revision surgery to fuse the progressive thoracic curve.Conclusion: Posterior selective TL/L fusion with pedicle screw constructs allows for spontaneous thoracic correction and maintains coronal and sagittal balance during the follow-up. Maximal correction instead of undercorrection was recommended for moderate Lenke 5C curves. Disc wedging could be improved after surgery and well maintained during the follow-up. [ABSTRACT FROM AUTHOR]

Published
2017
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2. Radiographic evaluation of posterior selective thoracolumbar or lumbar fusion for moderate Lenke 5C curves

Author

Yipeng Wang, Jianguo Zhang, Yang Yang, Yanbin Zhang, Jianwei Guo, Jianxiong Shen, Shengru Wang, and Guanfeng Lin

Subjects
Male, Reoperation, musculoskeletal diseases, medicine.medical_specialty, Thoracolumbar or lumbar, Maximal correction, Adolescent, Radiography, Idiopathic scoliosis, Selective fusion, Thoracic Vertebrae, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Lumbar, Pedicle Screws, medicine, Humans, Orthopedics and Sports Medicine, Child, Pedicle screw, Retrospective Studies, 030222 orthopedics, Fusion, Lumbar Vertebrae, business.industry, General Medicine, Orthopaedic Surgery, Surgery, Indication, Spinal Fusion, Treatment Outcome, Scoliosis, Disc wedging, Orthopedic surgery, Female, business, Nuclear medicine, 030217 neurology & neurosurgery
Abstract

Introduction Posterior selective thoracolumbar or lumbar (TL/L) fusion with pedicle screw constructs for adolescent idiopathic scoliosis (AIS) has been studied in a few researches. However, few studies have discussed the indication for selective TL/L fusion and the behaviors of its adjacent disc angle. The present study aims to discuss the indication for posterior selective TL/L fusion and the behavior of the adjacent disc angle. Methods 45 consecutive cases of AIS undergoing posterior selective TL/L fusion were retrospectively evaluated, with an average follow-up of 36 months. Radiographs were reviewed to determine the coronal curve magnitude and the sagittal alignment preoperatively, postoperatively and at final follow-up. Thoracic curves in groups A had a correction loss of more than 5°, while thoracic curves in group B had a correction loss of not more than 5°. Results The coronal curve magnitude of the TL/L curve averaged 44° preoperatively and it was corrected to 6° immediately with a correction rate of 84.8 %. At final follow-up it was 9° with a correction loss of 3°. The minor thoracic curve was 26° preoperatively, and the convex side bending curve magnitude averaged 8° with a flexibility of 72.7 %. It was corrected to 13° immediately with a spontaneous correction of 48.5 %. At final follow-up it was 14° with a correction loss of 1°. UIVA decreased from 4° to 2° after surgery, and it was 2° at final follow-up. LIVA decreased from 7° to 4° after surgery, and it was 5° at final follow-up. Maximal correction of TL/L curves in group A is significantly less than that in group B. 1 patient received revision surgery to fuse the progressive thoracic curve. Conclusion Posterior selective TL/L fusion with pedicle screw constructs allows for spontaneous thoracic correction and maintains coronal and sagittal balance during the follow-up. Maximal correction instead of undercorrection was recommended for moderate Lenke 5C curves. Disc wedging could be improved after surgery and well maintained during the follow-up.

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