TY - JOUR
T1 - Timing of Changes in Three-Dimensional Spinal Parameters After Selective Thoracic Fusion in Lenke 1 Adolescent Idiopathic Scoliosis
T2 - Two-Year Follow-up
AU - Pasha, Saba
AU - Flynn, John M.
AU - Sponseller, Paul D.
AU - Orlando, Giuseppe
AU - Newton, Peter O.
AU - Cahill, Patrick J.
N1 - Funding Information:
Author disclosures: Dr Pasha reports grants from SRS. Dr Flynn reports others from Wolters Kluwer Health, others from American Board of Orthopaedic Surgery, Inc. and personal fees from Biomet. Dr Sponseller reports personal fees from DePuy, A Johnson & Johnson Company, grants from A Johnson & Johnson Company, personal fees from Globus Medical, other from Journal of Bone and Joint Surgery, personal fees from Journal of Bone and Joint Surgeryoakstone medical, other from Scoliosis Research Society. Dr Orlando has nothing to disclose. Dr. Newton reports grants from Setting Scoliosis Straight Foundation, during the conduct of the study; grants and other from Setting Scoliosis Straight Foundation, other from Rady Children's Specialists, grants and personal fees from DePuy Synthes Spine, personal fees from Law firm of Carroll, Kelly, Trotter, Franzen & McKenna, personal fees from Law firm of Smith, Haughey, Rice & Roegge, grants from NIH, grants from OREF, grants and other from SRS, grants from EOS imaging, personal fees from Thieme Publishing, other from NuVasive, personal fees from Ethicon Endosurgery, other from Electrocore, personal fees from Cubist, other from International Orthopedic Think Tank, other from Orthopediatrics Institutional Support, personal fees from K2M, outside the submitted work; In addition, Dr. Newton has a patent Anchoring systems and methods for correcting spinal deformities (8540754) with royalties paid to DePuy Synthes Spine, a patent Low profile spinal tethering systems (8123749) issued to DePuy Spine, Inc., a patent Screw placement guide (7981117) issued to DePuy Spine, Inc., and a patent Compressor for use in minimally invasive surgery (7189244) issued to DePuy Spine, Inc.. Dr Cahill reports other from SRS, other from Journal of Bone and Joint Surgery, other from Pediatric Orthopaedic Society of North America, other from spine deformity, personal fees from Biogen, Inc. Setting Scoliosis Straight reports research grants to support Harms Study Group Research from DePuy Synthes Spine, K2M, Inc, EOS Imaging, and Zimmer Biomet. Additional educational funding support received from Ellipse technologies, Globus Medical, Lawall Prosthetics, Medtronic Spinal, NuVasive, Orthopediatrics, SpineGuard, Stryker Spine Midatlantic, Allied Orthopedic Associates, C.D. Denison Orthopaedic Appliance Corp, Mazor Robotics and Theraplay.
Publisher Copyright:
© 2017 Scoliosis Research Society
PY - 2017/11
Y1 - 2017/11
N2 - Study Design Retrospective analysis of the prospectively collected data. Objective To investigate the relationship between the axial rotation of the unfused lumbar spine and the parameters of the instrumented thoracic spine at varying time points after selective thoracic fusion (STF) in Lenke 1B and 1C adolescent idiopathic scoliosis (AIS). Summary of Background Data The impact of STF on the spontaneous lumbar curve correction in AIS has been studied mainly in the frontal planes. The relationship between the spontaneous transverse plane correction of the lumbar spine and the parameters of the fused thoracic spine is not well documented. Methods Twenty-one Lenke 1B and 1C patients who had received STF with minimum two years' follow-up were selected. Thoracic and lumbar Cobb angles, kyphosis, lordosis, and thoracic and lumbar apical vertebrae rotations were measured at preoperative, first-erect, six-month, one-year, and two-year follow-ups. The association between the lumbar apical vertebral rotation and other thoracic and lumbar variables at different time points were determined using regression analysis. The variables significantly predicting the lumbar axial rotation correction at two years were determined from the preceding follow-up visits. Results Kyphosis, thoracic Cobb, thoracic apical vertebral rotation, and lumbar Cobb were significantly different between the preoperative and all the postoperative follow-ups (p <.05). At the two-year follow-up, a decrease in thoracic rotation and lumbar Cobb and a higher residual thoracic Cobb were associated with an improved spontaneous lumbar rotation (R2 = 0.41, p <.05). Lumbar rotation at two years was predicted from thoracic derotation and lumbar Cobb at first erect (R2 = 0.30, p <.05). Conclusion Spontaneous lumbar curve rotation correction correlated to the fused and unfused spinal parameters in the three anatomic planes. The relationship between thoracic and lumbar rotation persist up to two years after STF. Thoracic derotation is an important factor determining the lumbar rotation correction at two years after STF.
AB - Study Design Retrospective analysis of the prospectively collected data. Objective To investigate the relationship between the axial rotation of the unfused lumbar spine and the parameters of the instrumented thoracic spine at varying time points after selective thoracic fusion (STF) in Lenke 1B and 1C adolescent idiopathic scoliosis (AIS). Summary of Background Data The impact of STF on the spontaneous lumbar curve correction in AIS has been studied mainly in the frontal planes. The relationship between the spontaneous transverse plane correction of the lumbar spine and the parameters of the fused thoracic spine is not well documented. Methods Twenty-one Lenke 1B and 1C patients who had received STF with minimum two years' follow-up were selected. Thoracic and lumbar Cobb angles, kyphosis, lordosis, and thoracic and lumbar apical vertebrae rotations were measured at preoperative, first-erect, six-month, one-year, and two-year follow-ups. The association between the lumbar apical vertebral rotation and other thoracic and lumbar variables at different time points were determined using regression analysis. The variables significantly predicting the lumbar axial rotation correction at two years were determined from the preceding follow-up visits. Results Kyphosis, thoracic Cobb, thoracic apical vertebral rotation, and lumbar Cobb were significantly different between the preoperative and all the postoperative follow-ups (p <.05). At the two-year follow-up, a decrease in thoracic rotation and lumbar Cobb and a higher residual thoracic Cobb were associated with an improved spontaneous lumbar rotation (R2 = 0.41, p <.05). Lumbar rotation at two years was predicted from thoracic derotation and lumbar Cobb at first erect (R2 = 0.30, p <.05). Conclusion Spontaneous lumbar curve rotation correction correlated to the fused and unfused spinal parameters in the three anatomic planes. The relationship between thoracic and lumbar rotation persist up to two years after STF. Thoracic derotation is an important factor determining the lumbar rotation correction at two years after STF.
KW - 3D spinal parameters
KW - Adolescent idiopathic scoliosis
KW - Axial plane parameters
KW - Predictive model
KW - Selective thoracic fusion
UR - https://www.scopus.com/pages/publications/85032036037
UR - https://www.scopus.com/pages/publications/85032036037#tab=citedBy
U2 - 10.1016/j.jspd.2017.04.003
DO - 10.1016/j.jspd.2017.04.003
M3 - Article
C2 - 29050718
AN - SCOPUS:85032036037
SN - 2212-134X
VL - 5
SP - 409
EP - 415
JO - Spine deformity
JF - Spine deformity
IS - 6
ER -