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学科主题: 临床医学
题名:
Lowest instrumented vertebra selection in Lenke 3C and 6C scoliosis: what if we choose lumbar apical vertebra as distal fusion end?
作者: Wang, Yu1,2; Bunger, Cody Eric1; Zhang, Yanqun1; Hansen, Ebbe Stender1
关键词: Adolescent idiopathic scoliosis ; Lowest instrumented vertebra ; Radiographic measurement ; Spinal imbalance ; Curve behaviour
刊名: EUROPEAN SPINE JOURNAL
发表日期: 2012-06-01
DOI: 10.1007/s00586-011-2058-1
卷: 21, 期:6, 页:1053-1061
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Clinical Neurology ; Orthopedics
研究领域[WOS]: Neurosciences & Neurology ; Orthopedics
关键词[WOS]: ADOLESCENT IDIOPATHIC SCOLIOSIS ; POSTERIOR THORACIC FUSION ; CURVE CORRECTION ; II CURVES ; DEROTATION ; ANTERIOR ; PERFORM ; BALANCE ; 1B
英文摘要:

The aim of this study was to investigate whether or not post-op curve behaviour differs due to different choices of lowest instrumented vertebra (LIV) with reference to lumbar apical vertebra (LAV) in Lenke 3C and 6C scoliosis.

We reviewed all the AIS cases surgically treated in our institution from 2002 through 2008. Inclusion criteria were as follows: (1) patients with Lenke 3C or 6C scoliosis who were treated with posterior pedicle screw-only constructs; (2) 2-year radiographic follow-up. All the included patients were categorized into three groups based on the relative position of LIV and LAV: Group A-the LIV was above the LAV; Group B-the LIV was at the LAV; Group C-the LIV was below the LAV. All the radiographic parameters were then compared among the groups. All image data were available in our picture archiving and communication systems. Standing anteroposterior (AP) and lateral digital radiographs were reviewed at four times (pre-op, post-op, 3-month and 2-year). In each standing AP radiograph, centre sacral vertical line (CSVL, the vertical line that bisects the proximal sacrum) was first drawn, followed by measuring T1-CSVL, LIV-CSVL, (LIV + 1)-CSVL, LAV-CSVL and thoracic AV-CSVL distance. In addition, the Cobb angles of major thoracic and lumbar curves were measured at the four times and the correction rates were then calculated.

Of the 278 patients reviewed, 40 met the inclusion criteria; 11 of these were included in Group A (LIV above LAV), another 11 in Group B (LIV at LAV) and the remaining 18 in Group C (LIV below LAV). At 2-year follow-up, the lumbar vertebrae such as LIV, LIV + 1 and LAV were all more deviated than before surgery in Group A (LIV above LAV), whereas in Group B and C (LIV at and below LAV) they were all less deviated than before surgery. No significant differences were found in thoracic or lumbar correction rate, global coronal balance and incidence rate of trunk shift among the three groups.

In conclusion, in Lenke 3C and 6C scoliosis, post-op lumbar curve behaviour differs due to different choices of LIV with reference to LAV, that is, the deviation of lumbar curve improves when the LIV is either at or below the LAV but deteriorates when the LIV is above the LAV. Although the greatest correction occurs when the LIV is below the LAV, choosing LAV as LIV can still be the optimal option in certain cases, since it can yield similar correction while preserving more lumbar mobility and growth potential.

语种: 英语
项目资助者: Danish Strategic Research Council
WOS记录号: WOS:000304855600004
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/61739
Appears in Collections:北京大学第一临床医学院_骨科_期刊论文

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作者单位: 1.Aarhus Univ Hosp, Dept Orthopaed E, DK-8000 Aarhus, Denmark
2.Peking Univ, Dept Orthopaed, Hosp 1, Beijing 100034, Peoples R China

Recommended Citation:
Wang, Yu,Bunger, Cody Eric,Zhang, Yanqun,et al. Lowest instrumented vertebra selection in Lenke 3C and 6C scoliosis: what if we choose lumbar apical vertebra as distal fusion end?[J]. EUROPEAN SPINE JOURNAL,2012,21(6):1053-1061.
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