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Spinal sagittal alignment and postoperative adding-on in patients with adolescent idiopathic scoliosis after surgery - 27/09/22

Doi : 10.1016/j.otsr.2022.103352 
Shu-Man Han 1, Jin-Xu Wen 1, Lei Cao, Hui-Zhao Wu, Chang Liu, Chen Yang, Hui-Hui Yang, Wen-Juan Wu , Bu-Lang Gao
 Department of Radiology, The Third Hospital of Hebei Medical University, 139, Ziqiang Road, Shijiazhuang 050051, Hebei Province, China 

Corresponding author.

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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 (P<0.05) 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°±7.1° for TK). The Cobb angle was significantly (19.65°±8.69° vs. 50.66°±11.46°; P<0.001) decreased after compared with that before surgery. At the final follow-up, the Cobb angle (26.48°±9.61° vs. 19.65°±8.69°, P<0.001), T1S (24.87°±5.11° vs. 20.04°±8.13°), and TK (41.88°±9.45° vs 33.53°±12.71°) all significantly (P<0.01) increased compared with those immediately after surgery. The Cobb angle significantly (26.48°±9.61° vs. 50.66°±11.46°, P<0.001) decreased while CL, T1S, and TK all significantly (8.32°±13.67° vs 2.47°±14.42° for CL, T1S 24.87°±5.11° vs. 21.28°±5.88° for T1S, and 41.88°±9.45° vs. 33.13°±10.97° 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.

El texto completo de este artículo está disponible en PDF.

Keywords : Adolescent idiopathic scoliosis, Cervical sagittal alignment, Cobb angle, Surgery


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© 2022  Publicado por Elsevier Masson SAS.
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Vol 108 - N° 6

Artículo 103352- octobre 2022 Regresar al número
Artículo precedente Artículo precedente
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