Curve Overcorrection Predicts Coronal Imbalance in Selective Thoracic Fusion in Adolescent Idiopathic Scoliosis
STUDY DESIGN: Retrospective cohort Study.
OBJECTIVES: To identify predictive factors for coronal imbalance after selective fusion in adolescent idiopathic scoliosis (AIS) with Lenke type 1 curves.
METHODS: AIS patients with Lenke type 1 curve with A, B and C lumbar modifiers underwent selective thoracic fusion. The curve fulcrum flexibility and fulcrum bending correction index (FBCI) was studied. Coronal imbalance was defined as more than 2 cm of truncal shift or more than 2 cm list at two-year follow-up.
RESULTS: A total of 301 patients were included in the study. Coronal imbalance at two-year follow-up was found in 38 patients (13%). At the preoperative stage, we found a significant difference in main curve flexibility with 66±15% in the balanced group and 60±15% in the imbalanced group (P = .032). At the immediate postoperative stage, mean curve correction was 71±13% vs 70±13% and mean FBCI was 112±29% vs 122±29% in the balance and unbalanced group, respectively (P = .031). Postoperative FBCI of more than 125% (third quartile) resulted in an odds ratio of 2.1 (95%CI:1.1-4.3) for coronal imbalance at two years (P=.031). No significant changes in fusion mass or LIV tilt was observed.
CONCLUSIONS: A decreased preoperative flexibility and a higher FBCI was significantly associated with coronal imbalance. A high FBCI is an indication of a curve correction that exceeds the inherent flexibility of the spine, and our results add to a growing body of evidence that "overcorrection" of the main curve can lead to postoperative imbalance.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:14 |
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| Enthalten in: |
Global spine journal - 14(2024), 3 vom: 03. Apr., Seite 856-861 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ohrt-Nissen, Søren [VerfasserIn] |
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| Links: |
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| Themen: |
Adolescent idiopathic scoliosis |
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| Anmerkungen: |
Date Revised 05.04.2024 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1177/21925682221124526 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM345628128 |
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| 245 | 1 | 0 | |a Curve Overcorrection Predicts Coronal Imbalance in Selective Thoracic Fusion in Adolescent Idiopathic Scoliosis |
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| 500 | |a Date Revised 05.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a STUDY DESIGN: Retrospective cohort Study | ||
| 520 | |a OBJECTIVES: To identify predictive factors for coronal imbalance after selective fusion in adolescent idiopathic scoliosis (AIS) with Lenke type 1 curves | ||
| 520 | |a METHODS: AIS patients with Lenke type 1 curve with A, B and C lumbar modifiers underwent selective thoracic fusion. The curve fulcrum flexibility and fulcrum bending correction index (FBCI) was studied. Coronal imbalance was defined as more than 2 cm of truncal shift or more than 2 cm list at two-year follow-up | ||
| 520 | |a RESULTS: A total of 301 patients were included in the study. Coronal imbalance at two-year follow-up was found in 38 patients (13%). At the preoperative stage, we found a significant difference in main curve flexibility with 66±15% in the balanced group and 60±15% in the imbalanced group (P = .032). At the immediate postoperative stage, mean curve correction was 71±13% vs 70±13% and mean FBCI was 112±29% vs 122±29% in the balance and unbalanced group, respectively (P = .031). Postoperative FBCI of more than 125% (third quartile) resulted in an odds ratio of 2.1 (95%CI:1.1-4.3) for coronal imbalance at two years (P=.031). No significant changes in fusion mass or LIV tilt was observed | ||
| 520 | |a CONCLUSIONS: A decreased preoperative flexibility and a higher FBCI was significantly associated with coronal imbalance. A high FBCI is an indication of a curve correction that exceeds the inherent flexibility of the spine, and our results add to a growing body of evidence that "overcorrection" of the main curve can lead to postoperative imbalance | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a FBCI | |
| 650 | 4 | |a Lenke 1 | |
| 650 | 4 | |a adolescent idiopathic scoliosis | |
| 650 | 4 | |a coronal imbalance | |
| 650 | 4 | |a listing | |
| 650 | 4 | |a selective fusion | |
| 650 | 4 | |a trunk shift | |
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| 700 | 1 | |a Kawasaki, Sachiko |e verfasserin |4 aut | |
| 700 | 1 | |a Shigematsu, Hideki |e verfasserin |4 aut | |
| 700 | 1 | |a Cheung, Jason Pui Yin |e verfasserin |4 aut | |
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