An analysis of preoperative shoulder and neck balance and surgical outcome in 111 adolescent idiopathic scoliosis patients with two subtypes of Lenke 1 curves.

التفاصيل البيبلوغرافية
العنوان:	An analysis of preoperative shoulder and neck balance and surgical outcome in 111 adolescent idiopathic scoliosis patients with two subtypes of Lenke 1 curves.
المؤلفون:	Wei Chan CY, Chiu CK, Ng YH, Goh SH, Ler XY, Ng SJ, Chian XH, Tan PH, Kwan MK
المصدر:	Journal of neurosurgery. Spine [J Neurosurg Spine] 2020 Aug 28; Vol. 34 (1), pp. 37-44. Date of Electronic Publication: 2020 Aug 28 (Print Publication: 2021).
نوع المنشور:	Journal Article
اللغة:	English
بيانات الدورية:	Publisher: American Association of Neurological Surgeons Country of Publication: United States NLM ID: 101223545 Publication Model: Electronic-Print Cited Medium: Internet ISSN: 1547-5646 (Electronic) Linking ISSN: 15475646 NLM ISO Abbreviation: J Neurosurg Spine Subsets: MEDLINE
أسماء مطبوعة:	Original Publication: Charlottesville, VA : American Association of Neurological Surgeons, c2004-
مواضيع طبية MeSH:	Spinal Fusion, Neck/physiopathology , Postural Balance/physiology , Scoliosis/physiopathology , Scoliosis/surgery , Shoulder/physiopathology, Adolescent ; Child ; Female ; Humans ; Male ; Pedicle Screws ; Radiography ; Retrospective Studies ; Scoliosis/diagnostic imaging ; Treatment Outcome ; Young Adult
مستخلص:	Objective: The incidence of postoperative shoulder imbalance following posterior spinal fusion (PSF) is still high in Lenke 1 curves despite following current treatment recommendations for upper instrumented vertebra (UIV) selection. The objective of this retrospective study was to identify differences in preoperative shoulder balance and to report the surgical outcome of two subtypes of Lenke 1 curves (flexible vs stiff) in patients with adolescent idiopathic scoliosis (AIS). Methods: The authors grouped patients' curves as Lenke 1-ve (flexible) when their preoperative proximal thoracic side bending (PTSB) Cobb angle was < 15° and as Lenke 1+ve (stiff) when the PTSB Cobb angle was 15°-24.9°. The authors hypothesized that these two subtypes had distinct preoperative and postoperative shoulder and neck balance following PSF using pedicle screw constructs. Results: Fifty patients had Lenke 1 (flexible) curves and 61 had Lenke 1 (stiff) curves. The mean preoperative T1 tilt for patients with Lenke 1 (flexible) was -4.9° ± 5.3°, and for those with Lenke 1 (stiff) curves it was -1.0° ± 5.3° (p < 0.001). Mean cervical axis (CA) was -0.1° ± 3.2° for Lenke 1 (flexible) curves and 2.3° ± 3.5° for Lenke 1 (stiff) curves (p < 0.001). Preoperative radiographic shoulder height (RSH) and clavicle angle (Cla-A) were similar between the two curve subtypes. Following surgery, there were significant differences between the subtypes in terms of T1 tilt (p < 0.001), RSH (p = 0.014), and Cla-A (p = 0.031). Interestingly, 41.0% of patients with a Lenke 1 (stiff) curve had +ve T1 tilt compared to 2.0% in Lenke 1 (flexible) group. Moreover, 26.2% of patients with the Lenke 1 (stiff) curve had +ve RSH compared to 12.0% of those with Lenke 1 (flexible) curves. And, 24.6% of patients with Lenke 1 (stiff) had +ve Cla-A compared to 10.0% of those with Lenke 1 (flexible) curves. Conclusions: Lenke 1 (flexible) and Lenke 1 (stiff) curves had distinct preoperative T1 tilt and CA measurements. Following PSF, the authors noted +ve T1 tilt in 41% of patients with Lenke 1 (stiff) curves versus 2.0% in those with Lenke 1 (flexible) curves. The authors also noted a significant difference in postoperative RSH and Cla-A measurements.
فهرسة مساهمة:	Keywords: Lenke 1; T1 tilt; adolescent idiopathic scoliosis; cervical axis; cervical supine side bending; deformity; imbalance; neck; proximal thoracic; shoulder; subtype; upper instrumented vertebra
تواريخ الأحداث:	Date Created: 20200829 Date Completed: 20211110 Latest Revision: 20240813
رمز التحديث:	20240813
DOI:	10.3171/2020.5.SPINE20397
PMID:	32858516
قاعدة البيانات:	MEDLINE

الوصف
تدمد:	1547-5646
DOI:	10.3171/2020.5.SPINE20397