Variations de l’équilibre sagittal de la colonne vertébrale après arthrodèse vertébrale postérieure, perte de correction et traitement par corset chez les adolescents avec une scoliose idiopathique - 27/09/22
Spinal sagittal alignment and postoperative adding-on in patients with adolescent idiopathic scoliosis after surgery
Abstract |
Introduction |
Surgery for patients with adolescent idiopathic scoliosis (AIS) may change spinal sagittal alignment, and postoperative adding-on may affect spinal sagittal balance after reconstruction. This study was to investigate the effect of surgery on spinal sagittal alignment and the relationship between postoperative adding-on and spinal sagittal balance in patients with AIS.
Hypothesis |
The hypothesis of this study was that the effect of surgery on AIS was associated with recovery of the spinal sagittal plane and that presence of postoperative adding-on might affect the spinal sagittal balance.
Materials and methods |
This retrospective study enrolled 22 patients who received surgical treatment. Clinical, imaging and follow-up data were analyzed.
Results |
After surgery, T1 slope (T1S) and thoracic kyphosis (TK) were significantly (p<0.05) lower in patients with postoperative adding-on (16.73°±6.12° for T1S and 28.95°±11.3°for TK) than those without adding-on (24.82°±8.59°for T1S and 40.29°±12.08°for TK). At the last follow-up, cervical lordosis (CL), T1S, and TK were significantly lower in patients with adding-on (3.05°±11.41°for CL, 22.12°±3.68° for T1S, and 37.89°±8.97° for TK) than those without adding-on (15.94°±13.6° for CL, 28.86°±4.26 for T1S, and 47.64°±7.1̊ for TK). The Cobb angle was significantly (19.65̊±8.69̊vs. 50.66̊±11.46̊; p<0.001) decreased after compared with that before surgery. At the final follow-up, the Cobb angle (26.48̊±9.61̊ vs. 19.65±8.69, p<0.001), T1S (24.87̊±5.11̊vs. 20.04̊±8.13̊), and TK (41.88̊±9.45̊ vs. 33.53̊±12.71̊) all significantly (p<0.01) increased compared with those immediately after surgery. The Cobb angle significantly (26.48̊±9.61° vs. 50.66̊±11.46°, p<0.001) decreased while CL, T1S, and TK all significantly (8.32̊±13.67̊vs. 2.47̊±14.42̊for CL, T1S 24.87̊±5.11̊vs. 21.28̊±5.88̊ for T1S, and 41.88̊±9.45̊ vs. 33.13̊±10.97̊ for TK, p<0.05) increased at the final follow-up compared with those before surgery.
Discussion |
Surgery affects spinal sagittal alignment, and postoperative adding-on may affect spinal sagittal balance after reconstruction. Surgery as the ultimate approach for AIS has good effects but may result in some side effects.
Level of proof |
III, retrospective cohort study.
Le texte complet de cet article est disponible en PDF.Keywords : Adolescent idiopathic scoliosis, Cervical sagittal alignment, Cobb angle, Surgery
| ☆ | Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus. |
Vol 108 - N° 6
P. 778 - octobre 2022 Retour au numéro
Article précédent
- Bending et limite inférieure d’instrumentation dans les scolioses idiopathiques. Étude des pratiques professionnelles en France
- Roxane Compagnon, Baptiste Brun-Cottan, Kariman Abelin-Genevois, Audrey Angelliaume, Emmanuelle Ferrero, Christophe Garin, Brice Ilharreborde, Jean-Luc Jouve, Yan Lefevre, Christian Morin, Raphaël Vialle, Franck Accadbled, Jérôme Sales de Gauzy, Sébastien Pesenti, Tristan Langlais
- Pertes hématiques non détectées pendant la chirurgie de la scoliose
- Joshua M. Kolz, Kevin M. Neal
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?