Comparison of Implant Density in the Management of Lenke 1b and 1c Adolescent Idiopathic Scoliosis

Kılınç, Bekir Eray; Tran, Dong Phuong; Johnston, Charles E.

doi:10.1590/1413-785220192701189400

Cited by 9 publications

(5 citation statements)

References 29 publications

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“…Similar results were reported by Garcia et al (10) who included 79 patients and there was a statistically significant difference in the postoperative Cobb angle as compared to the preoperative Cobb angle (7° vs 53°) respectively. The results of the current study also agree with Kilinc et al (11) who showed that the preoperative mean main thoracic Cobb angle measured 61.2° and corrected to 25.3° postoperatively, and was 28.5° at 2-year follow-up.…”

Section: Radiological Outcomessupporting

confidence: 92%

Surgical Outcome of Three-Dimensional Correction of Adolescent Idiopathic Scoliosis

Ali¹,

El-deen²,

Ibrahim³

et al. 2021

The Egyptian Journal of Hospital Medicine

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Background: Adolescent idiopathic scoliosis is an abnormal curvature of the spine that appears in late childhood or adolescence. Instead of growing straight, the spine develops a side-to-side curvature, usually in an elongated "S" or "C" shape; the bones of the spine are also slightly twisted or rotated. To prevent further curve progression and obtain a balanced spine, surgery remains the mainstay of treatment for idiopathic scoliosis (IS).Objective: This study aimed to discuss three dimensional surgical techniques used for correction of adolescent idiopathic scoliosis, evaluating their feasibility, efficacy and safety. Patients and methods: This study was conducted in Mansoura University Hospital and Alexandria University Hospitals between September 2018 and April 2021. 3D surgical correction was performed for 91 patients complaining of idiopathic scoliosis, and not responding to conservative measures and not associated with neurological affection. Results: According to Lenke classification, there were 56 patients (61.5%) with type 1 curve type , 9 patients (9.9%) with type 2, 7 patients (7.7%) with type 3, 7 patients (7.7%) with type 5 and 12 patients (13.2%) with type 6. Mean preoperative height was 1.60 m while mean postoperative height was 1.66 m. with significant increase in height postoperatively (p < 0.001). Mean percentage height gain was 3.91%. Conclusion:We do believe that the posterior only approach 3D correction is an effective method in management of AIS concerning correction of Cobb angle, shoulder balance and spinopelvic parameters and recommend it as the best way nowadays to treat this disease.

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Section: Radiological Outcomessupporting

confidence: 92%

Surgical Outcome of Three-Dimensional Correction of Adolescent Idiopathic Scoliosis

Ali¹,

El-deen²,

Ibrahim³

et al. 2021

The Egyptian Journal of Hospital Medicine

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show abstract

“…Some authors reported that, in patients with high implant density, a significantly better correction rate could be achieved; however, there was no difference in the postoperative coronal balance and trunk shift. 33 In contrast, Shen et al, in a retrospective study of 62 adolescent idiopathic scoliosis (AIS) patients who underwent PSF, found that there was no significant difference in the correction rate of the main thoracic curve between the low and high implant density groups. 34 The involvement of two attending surgeons distinguishes the current study from previous reports.…”

Section: Discussionmentioning

confidence: 98%

Perioperative outcome of severe rigid idiopathic scoliosis: Single-staged posterior spinal fusion utilizing a dual attending surgeon strategy. A report of 41 patients

Chan

Chung

Mihara

et al. 2020

J Orthop Surg (Hong Kong)

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Purpose: Various surgical strategies including combined approach and spinal osteotomies in severe rigid scoliosis had been reported with significant perioperative complication rates. The use of single-staged posterior spinal fusion (PSF) utilizing a dual attending surgeon strategy for severe rigid scoliosis has not been widely reported. Methods: This was a retrospective study aimed to evaluate the perioperative outcome of single-staged PSF in severe rigid idiopathic scoliosis patients (Cobb angle ≥90° and ≤30% flexibility). Forty-one patients with severe rigid idiopathic scoliosis who underwent single-staged PSF were included. The perioperative outcome parameters were operation duration, intraoperative blood loss, intraoperative hemodynamic parameters, preoperative and postoperative hemoglobin, transfusion rate, patient-controlled anesthesia morphine usage, length of postoperative hospital stay, and perioperative complications. Radiological parameters included preoperative and postoperative Cobb angle, correction rate, side-bending flexibility, and side-bending correction index. Results: The mean age was 16.9 ± 5.6 years. The mean preoperative Cobb angle was 110.8 ± 12.1° with mean flexibility of 23.1 ± 6.3%. The mean operation duration was 215.5 ± 45.2 min with mean blood loss of 1752.6 ± 830.5 mL. The allogeneic blood transfusion rate was 24.4%. The mean postoperative hospital stay was 76.9 ± 26.7 h. The mean postoperative Cobb angle and correction rate were 54.4 ± 12.8° and 50.9 ± 10.1%, respectively. The readmission rate in this cohort was 2.4%. Four perioperative complications were documented (9.8%), one somatosensory evoke potential signal loss, one superficial infection, one lung collapse, and one superior mesenteric artery syndrome. Conclusions: Severe rigid idiopathic scoliosis treated with single-staged PSF utilizing a dual attending surgeon strategy demonstrated an average correction rate of 50.9%, operation duration of 215.5 min, and postoperative hospital stay of 76.9 h with a 9.8% perioperative complication rate.

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“…Previous authors have reported that higher implant density increased surgical time. Kilinc et al, 23 in his review of 120 patients, reported that the high-density group ( > 1.4 screws per level) had significantly longer surgical time (293.6 ± 73.1 min) compared with the low-density group (251.0 ± 68.1 min) (P < 0.001). Shen et al 24 reported a shorter operation duration in the low-density group (278.4 vs. 331.0 min, P = 0.004).…”

Section: Discussionmentioning

confidence: 99%

Factors Affecting Operation Duration in Posterior Spinal Fusion (PSF) Using Dual Attending Surgeon Strategy Among Lenke 1 and 2 Adolescent Idiopathic Scoliosis (AIS) Patients

Chung

Mihara

Chiu

et al. 2021

Clinical Spine Surgery: A Spine Publication

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of Background Data: Prolonged operation duration in adolescent idiopathic scoliosis (AIS) surgery was associated with increased perioperative complications. However, the factors affecting operation duration in AIS surgery were unknown.Objective: The aim of the study was to investigate the factors affecting operation duration in posterior spinal fusion (PSF) surgery using a dual attending surgeon strategy among Lenke 1 and 2 AIS patients.Methods: In all, 260 AIS patients with Lenke 1 and 2 curves who underwent PSF were retrospectively reviewed. Preoperative and intraoperative factors affecting operation duration such as age, sex, height, weight, body mass index, Risser grade, Lenke subtypes, number of fusion level, number of screws, screw density, wound length, upper and lowest instrumented vertebrae level, preoperative Cobb angle, and flexibility of the major curve were assessed using univariate and multivariate linear regression analyses. Independent factors were determined when P-value <0.05. Results:The mean operation duration was 122.2 ± 28.6 minutes. Significant independent factors affecting operation duration in PSF among Lenke 1 and 2 AIS patients were Lenke 2 subtypes (β = 8.86, P = 0.008), number of screws (β = 7.01, P < 0.001), wound length (β = 1.14, P = 0.009), and flexibility of the major curve (β = −0.25, P = 0.005). The overall model fit was R 2 = 0.525. Operation duration can be predicted using the formula: (8.86×Lenke subtypes) +(7.01×number of screws)+(1.14×wound length)−(0.25×flexibility) −0.54, where Lenke 2 = 1 and Lenke 1 = 0. Conclusion:The factors affecting operation duration in PSF among Lenke 1 and 2 AIS patients were Lenke 2 curves, number of screws, wound length, and curve flexibility. The knowledge of these factors enables the spinal deformity surgeons to plan and estimate the operation duration before AIS surgery.

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Comparison of Implant Density in the Management of Lenke 1b and 1c Adolescent Idiopathic Scoliosis

Cited by 9 publications

References 29 publications

Surgical Outcome of Three-Dimensional Correction of Adolescent Idiopathic Scoliosis

Surgical Outcome of Three-Dimensional Correction of Adolescent Idiopathic Scoliosis

Perioperative outcome of severe rigid idiopathic scoliosis: Single-staged posterior spinal fusion utilizing a dual attending surgeon strategy. A report of 41 patients

Factors Affecting Operation Duration in Posterior Spinal Fusion (PSF) Using Dual Attending Surgeon Strategy Among Lenke 1 and 2 Adolescent Idiopathic Scoliosis (AIS) Patients

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