Anterior versus posterior spinal fusion for Lenke type 5 adolescent idiopathic scoliosis: a systematic review and meta-analysis of comparative studies

Hirase, Takashi; Ling, Jeremiah; Haghshenas, Varan; Thirumavalavan, Jeyvikram; Dong, David; Hanson, Darrell S; Marco, Rex A.W.

doi:10.1007/s43390-021-00436-x

Cited by 11 publications

(24 citation statements)

References 40 publications

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“…23,42 Many studies showed that the Lenke type 5 AIS patients who underwent ASF needed more time to recover, which may contribute to the prolonged hospital stay time. 6 Our results indicated that the blood loss of the two groups was not significantly different. Although ASF has fewer fusion segments and minor trauma without damaging the posterior muscle-ligament complex may be likely to reduce blood loss.…”

Section: Operation Time Duration Of Hospital Stays and Estimated Bloo...mentioning

confidence: 53%

“…6 Furthermore, many studies reported the loss of correction between postoperation and final follow-up in the two approaches. 20,21 Two previous published meta-analyses 5,6 have focused on the same topic as this study. However, they do not thoroughly analyze the outcomes mentioned above in the long-term follow-up, such as the loss of correction in the TL/L and thoracic curves and changes in the coronal and sagittal balance parameters.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to the TL/L curve correction of Lenke type 5, studies should also pay attention to the compensatory thoracic curve and trunk shift (TS) correction to evaluate the overall correction of the coronal plane 6 . Studies had shown no significant difference in the compensatory thoracic curve correction of Lenke type 5 AIS between the ASF and PSF 8,12 .…”

mentioning

confidence: 99%

“…With the popularization of pedicle screw technology, posterior spinal fusion (PSF) has become the mainstream correction operation of AIS and adult spinal deformity 3,4 . However, there is a lack of consensus on coronal plane correction of TL/L and thoracic curves by anterior spinal fusion (ASF) and PSF in Lenke type 5 AIS 5,6 . In the long-term follow-up, most studies showed that PSF had a larger or equal correction degree for the TL/L curve versus ASF 6 .…”

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confidence: 99%

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Surgical Treatment of Scoliosis Lenke type 5, Anterior versus Posterior, which Approach is Better? A Systematic Review and Meta-analysis

Liang

Han

Sun

et al. 2022

Spine

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Study Design. Systematic review and meta-analysis.Objective. This study aimed to compare the radiographical and clinical outcomes between anterior spinal fusion (ASF) and posterior spinal fusion (PSF) in Lenke type 5 adolescence idiopathic scoliosis. Summary of Background Data. PSF has been the standard operation for adolescence idiopathic scoliosis. ASF can also achieve a good curve correction effect with fewer fusion segments and minor invasion of paraspinal structures. Materials and Methods. A systematic literature research was conducted in PubMed, Embase, Cochrane Library, and Web of Science. Use meta-analysis to compare the changes of thoracolumbar/ lumbar and thoracic curves and other important outcomes between ASF and PSF. Results. A total of 427 ASF and 392 PSF patients from 12 studies were included. There was no significant difference in the correction degree of thoracolumbar/lumbar and thoracic curve between ASF and PSF (P > 0.05), except for PSF had more compensatory correction degree of thoracic curve at postoperation (P < 0.05). Besides, the loss of correction in thoracic curve in PSF at the last follow-up was significantly less than that in ASF (P < 0.05). PSF presented larger change values of thoracic kyphosis and lumbar lordosis at the last follow-up (P < 0.05). PSF showed a better effect in correcting trunk shift distance at the postoperation (P < 0.05) but less trunk shift distance correction from postoperation to last follow-up (P < 0.05). There was no significant difference in the incidence of proximal junctional kyphosis and estimated blood loss between the two approaches (P > 0.05). Moreover, ASF showed fewer fusion segments, but longer operation and hospital stay time (P < 0.05). Conclusion. ASF is capable of achieving similar correction in coronal curve and balance as PSF with fewer fusion segments. Spine surgeons should select an appropriate approach tailored to individual patients needs while considering procedural risks and benefits.

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Section: Operation Time Duration Of Hospital Stays and Estimated Bloo...mentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Surgical Treatment of Scoliosis Lenke type 5, Anterior versus Posterior, which Approach is Better? A Systematic Review and Meta-analysis

Liang

Han

Sun

et al. 2022

Spine

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“…Moreover, many recent studies have highlighted the conclusion that the correction rate of the posterior approach is similar to that of the anterior approach and the complications associated with the anterior approach. Posterior spinal fusion has become the standard option for AIS because it can achieve satisfactory curve correction, achieve three-dimensional correction, relieve vertebral rotation, reduce blood loss and operation time, shorten hospitalization time, and reduce costs (31,32).…”

Section: Discussionmentioning

confidence: 99%

Anterior versus posterior approach in Lenke type 1 adolescent idiopathic scoliosis: a comparison of long-term follow-up outcomes

Dai

et al. 2022

Ann Transl Med

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Background: After surgical treatment of adolescent idiopathic scoliosis (AIS), doctors should not only focus on the short-term surgical effect, but also pay special attention to whether the patients can live normally in the long-term. This work compared the long-term effects of thoracoscopy-assisted anterior spinal fusion (ASF) and posterior spinal fusion (PSF) in AIS.Methods: Twenty-two patients underwent thoracoscopy-assisted ASF, and twenty-three patients underwent PSF from 2004 to 2009 were involved , including 14 males and 31 females with an average age of 14.8±2.6 years, and all patients suffered from only Lenke type 1 AIS. The mean follow-up time was 102 months, the radiographic parameters and operation time, hospitalization time, fusion segments and estimated blood loss were evaluated. Comparisons between groups were made such as Cobb's angle, thoracic kyphosis, the instrumented levels, curve correction, preoperative parameters, SF-36/SRS-22 questionnaire scores, and pulmonary function.Results: There was no significant difference in age, gender, Risser sign and follow-up period between two groups. The instrumentation level had an average of 6 in the thoracoscopy-assisted ASF group and 9.7 in the PSF group (P<0.001). The average correction rate of the main curve was 67.4% in ASF group versus 79.2% in PSF group (P>0.05). The postoperative thoracic kyphosis was 16.2°±3.9° in ASF group and 25.6°±4.4° in PSF group (P=0.023). Patients had momentous advancement in self-image, vitality and mental health in the SRS-22 and SF-36 questionnaires. Compared to preoperatively, the pulmonary function of both groups was satisfactorily improved at the final follow-up.Conclusions: Since there was no statistically significant difference in the general conditions of the two groups selected for this study, so we finally concluded that thoracoscopy-assisted ASF had a satisfactory correction rate, famous long-term radiography outcomes and desirable pulmonary function results. However, compared to PSF, it has a longer operation time, a more complicated surgical procedure and a weaker threedimensional correction effect, and PSF has affirmative long-term outcomes, fewer complications, and satisfactory sagittal balance, all of which make PSF the standard operation to treat AIS.

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Anterior Solid Dual‐Rod Instrumentation and Fusion for Flexible Thoracolumbar or Lumbar Spinal Deformities in Adolescent Idiopathic Scoliosis

Noe,

Furlough,

Schwend

2024

Journal of the Pediatric Orthopaedic Society of North America

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Anterior versus posterior spinal fusion for Lenke type 5 adolescent idiopathic scoliosis: a systematic review and meta-analysis of comparative studies

Cited by 11 publications

References 40 publications

Surgical Treatment of Scoliosis Lenke type 5, Anterior versus Posterior, which Approach is Better? A Systematic Review and Meta-analysis

Surgical Treatment of Scoliosis Lenke type 5, Anterior versus Posterior, which Approach is Better? A Systematic Review and Meta-analysis

Anterior versus posterior approach in Lenke type 1 adolescent idiopathic scoliosis: a comparison of long-term follow-up outcomes

Anterior Solid Dual‐Rod Instrumentation and Fusion for Flexible Thoracolumbar or Lumbar Spinal Deformities in Adolescent Idiopathic Scoliosis

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