Analysing the change of sagittal balance in patients with Lenke 5 idiopathic scoliosis
Objective: The aim of this study was to evaluate preoperative and postoperative spinopelvic parameters and the influence of lowest instrumented vertebrae on sagittal parameters in Lenke 5 Adolescent Idiopathic Scoliosis (AIS) patients. Methods: A total of 42 patients (37 females, 5 males; mean age: 16.71 ± 3.46 years) were included in the study. Preoperative and postoperative last follow up lumbar lordosis (LL), thoracic kyphosis (TK), pelvic tilt (PT), pelvic incidence (PI) and sacral slope (SS) angles measured. By stopped fusion in L3, L4 or L5 we divided the group into three parts. Results: Mean follow-up was 43 months. Preoperatively, the mean TK and LL were 36.8 and 55.3 . At the last follow up, the mean TK and LL were 27.1 and 49.0 degrees, respectively. Preoperatively, the mean PI, PT and SS were 53.3 , 16.1 and 37.4 degrees. At the last follow up, the mean PI, PT and SS were 52.7 , 19.9 and 33.0 respectively. Significant differences were observed for SS (p = 0.003), TK (p = 0.004), LL (p = 0.012) and PT (p = 0.013) postoperatively for all patients. According the L3 and L4 groups there is significant difference in SS, LL (p = 0.013) and PT (p = 0.018) which means a significant decrease occurs in SS and LL when the distal fusion level changes from L3 to L4 but significant increase in PT in L3 group to compensate spinopelvic change after surgery. Conclusion: The selection of more distal level for fusion adversely affects the compensation mechanisms of sagittal balance in Lenke 5 AIS patients.
___
1. Legaye J, Duval-Beaupere G, Hecquet J, Marty C. Pelvic incidence: a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves. Eur Spine J. 1998;7(2):99e103.2. Berthonnaud E, Dimnet J, Roussouly P, Labelle H. Analysis of the sagittal balance of the spine and pelvis using shape and orientation parameters. J Spinal Disord Tech. 2005;18(1):40e47.
3. Mac-Thiong JM, Labelle H, Charlebois M, Huot MP, de Guise JA. Sagittal plane analysis of the spine and pelvis in adolescent idiopathic scoliosis according to the coronal curve type. Spine (Phila Pa 1976). 2003;28(13):1404e1409.
4. Upasani VV, Tis J, Bastrom T, et al. Analysis of sagittal alignment in thoracic and thoracolumbar curves in adolescent idiopathic scoliosis: how do these two curve types differ? Spine (Phila Pa 1976). 2007;32(12):1355e1359.
5. Yang X, Liu L, Song Y, et al. Pre- and postoperative spinopelvic sagittal balance in adolescent patients with lenke type 5 idiopathic scoliosis. Spine (Phila Pa 1976). 2015;40(2):102e108.
6. La Maida GA, Zottarelli L, Mineo GV, Misaggi B. Sagittal balance in adolescent idiopathic scoliosis: radiographic study of spino-pelvic compensation after surgery. Eur Spine J. 2013;22(suppl 6):S859eS867.
7. Xu XM, Wang F, Zhou XY, et al. Sagittal balance in adolescent idiopathic scoliosis: a radiographic study of spinopelvic compensation after selective posterior fusion of thoracolumbar/lumbar (Lenke 5C) curves. Medicine (Baltimore). 2015;94(45):e1995.
8. Clement JL, Geoffray A, Yagoubi F, et al. Relationship between thoracic hypokyphosis, lumbar lordosis and sagittal pelvic parameters in adolescent idiopathic scoliosis. Eur Spine J. 2013;22(11):2414e2420.
9. Tanguay F, Mac-Thiong JM, de Guise JA, Labelle H. Relation between the sagittal pelvic and lumbar spine geometries following surgical correction of adolescent idiopathic scoliosis. Eur Spine J. 2007;16(4):531e536.
10. Mac-Thiong JM, Berthonnaud E, Dimar 2nd JR, Betz RR, Labelle H. Sagittal alignment of the spine and pelvis during growth. Spine (Phila Pa 1976). 2004;29(15):1642e1647.
11. Roussouly P, Labelle H, Rouissi J, Bodin A. Pre- and post-operative sagittal balance in idiopathic scoliosis: a comparison over the ages of two cohorts of 132 adolescents and 52 adults. Eur Spine J. 2013;22(suppl 2):S203eS215.
12. Barrey C, Roussouly P, Le Huec JC, D'Acunzi G, Perrin G. Compensatory mechanisms contributing to keep the sagittal balance of the spine. Eur Spine J. 2013;22(suppl 6):S834eS841.
13. Schwab F, Lafage V, Patel A, Farcy JP. Sagittal plane considerations and the pelvis in the adult patient. Spine (Phila Pa 1976). 2009;34(17):1828e1833.
14. Yong Q, et al. Comparison of sagittal spinopelvic alignment in Chinese adolescents with and without idiopathic thoracic scoliosis. Spine (Phila Pa 1976). 2012;37(12):E714eE720.
15. Vaz G, Roussouly P, Berthonnaud E, Dimnet J. Sagittal morphology and equilibrium of pelvis and spine. Eur Spine J. 2002;11(1):80e87.
16. Lenke LG, Betz RR, Harms J, et al. Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis. J Bone Jt Surg Am. 2001;83- A(8):1169e1181.
17. Rinella A, Bridwell K, Kim Y, et al. Late complications of adult idiopathic scoliosis primary fusions to L4 and above: the effect of age and distal fusion level. Spine (Phila Pa 1976). 2004;29(3):318e325.
18. Newton PO, Yazsay P, Upasani VV, et al. Preservation of thoracic kyphosis is critical to maintain lumbar lordosis in the surgical treatment of adolescent idiopathic scoliosis. Spine (Phila Pa 1976). 2010;35(14):1365e1370.
19. Wang Y, Bünger CE, Zhang Y, et al. Lowest instrumented vertebra selection for Lenke 5C scoliosis: a minimum 2-year radiographical follow-up. Spine (Phila Pa 1976). 2013;38(14):E894eE900.
20. Li J, Hwang SW, Shi Z, et al. Analysis of radiographic parameters relevant to the lowest instrumented vertebrae and postoperative coronal balance in Lenke 5C patients. Spine (Phila Pa 1976). 2011;36(20):1673e1678.
21. Tao F, Shi Z, Xie Y, et al. Determination of lowest instrumented vertebra by the location of apical vertebra in Lenke type 1 adolescent idiopathic scoliosis. Int Orthop. 2011;35(4):561e567.
22. Hu PP, Yu M, Liu XG, Chen ZQ, Liu ZJ. Correlation analysis between the sagittal and coronal parameters of spino-pelvic in Lenke type 1 adolescent idiopathic scoliosis. Beijing Da Xue Xue Bao. 2015;47(2):248e252.
23. Hu P, Yu M, Liu X, et al. Analysis of the relationship between coronal and sagittal deformities in adolescent idiopathic scoliosis. Eur Spine J. 2016;25(2): 409e416.
- ISSN: 1017-995X
- Başlangıç: 2015
- Yayıncı: Türk Ortopedi ve Travmatoloji Derneği
Sayıdaki Diğer Makaleler
Fast Track Review: Definition and Feasibility
Short-term results of the management of severe bone defects in primary TKA with cement and K-wires
Muhammet Sadık BİLGEN, Gokay EKEN, Nejat GÜNEY
Factors affecting lifespan following below-knee amputation in diabetic patients
SALİH BEYAZ, ÜMİT ÖZGÜR GÜLER, Gülay ŞİMŞEK BAĞIR
Chao CHEN, Li YU, Xin TANG, Mo-zhen LİU, Li-zhong SUN, Changjian LİU, Zhen ZHANG, Chang-zhou Lİ
Mohammad Reza SOBHAN, Masoud MEHDİNEJAD, Mohammad Hossein JAMALADİNİ, Mahta MAZAHERİ, Masoud SHEHNEH ZARE, Hossein NEAMATZADEH
The assessment of portal-tract healing after knee arthroscopy
Nihat ACAR, Ali ER, MEHMET ERDURAN
O. Fuad OKEN, A. Ozgur YİLDİRİM, Mehmet ASİLTÜRK
The giant cell tumour of the proximal phalanx of the thumb treated by a 2-stage operation
Pawel REİCHERT, Przemyslaw KOWALSKİ, Jerzy GOSK
Analysing the change of sagittal balance in patients with Lenke 5 idiopathic scoliosis
Okan OZKUNT, Gokhan KARADEMİR, Kerim SARIYILMAZ, HALİL CAN GEMALMAZ, FATİH DİKİCİ, Ünsal DOMANİÇ