Sagittal balance correction of idiopathic scoliosis using the in situ contouring technique

Charles, Yann Philippe; Bouchaïb, Julia; Walter, Axel; Schuller, S.; Sauleau, Erik-André; Steib, Jean-Paul

doi:10.1007/s00586-012-2356-2

Cited by 14 publications

(11 citation statements)

References 27 publications

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“…Group mean values for maximal thoracic, thoracolumbar and lumbar rotation were lower than those found in the literature 9 , 10 ; however, this may be due to the fact that scoliosis patients not reaching the indication for surgery were also included. A wider range for maximal rotation was seen than that described in previous studies, with Th4-Th5, Th11-12, and L4 vertebrae also observed.…”

Section: Discussionmentioning

confidence: 65%

“…Kotwicki et al 9 found maxAVR was between 10 and 24 close to the T9 vertebra in Lenke 1 patients. Charles et al 10 found the maximal thoracic vertebral rotation between T6 and T10 vertebrae, with an average of 22.7 in standing position and the maximal lumbar vertebral rotation was measured at an average of 25.8 and was found at L1 and L3 vertebrae in Lenke 3 patients.…”

Section: Introductionmentioning

confidence: 96%

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Maximal Axial Vertebral Rotation in Adolescent Idiopathic Scoliosis: Is the Apical Vertebra the Most Rotated?

József

Schlégl

Burkus

et al. 2020

Global Spine Journal

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Study Design: Retrospective cross-sectional study. Objectives: It is generally believed that the apical vertebra has the largest axial rotation in adolescent idiopathic scoliosis. We investigated the relationship between apical axial vertebral rotation (apicalAVR) and maximal axial vertebral rotation (maxAVR) in both major and minor curves using biplanar stereo-imaging. Methods: EOS 2D/3D biplanar radiograph images were collected from 332 patients with adolescent idiopathic scoliosis (Cobb angle range 10°-122°, mean age 14.7 years). Based on the X-ray images, with the help of 3D full spine reconstructions Cobb angle, curvature level, apicalAVR and maxAVR were determined. These parameters were also determined for minor curves in Lenke 2, 3, 4, 6 type patients. Maximal thoracic rotation and maximal thoracolumbar/lumbar rotation were calculated. Statistical analysis was performed with descriptive statistics, Shapiro-Wilk test, and Wilcoxon signed-rank test. Results: The apical vertebrae were the most rotated vertebra in only 40.4% of the major curves, and 31.7% in minor curves. MaxAVR significantly exceeded apicalAVR values in the major curves ( P < .001) as well as in minor curves ( P < .001). The 2 parameters differed significantly in each severity group and Lenke type. Conclusions: The apical vertebrae were not the most rotated vertebra in more than half of cases investigated indicating that apicalAVR and maxAVR should be considered as 2 distinct parameters, of which maxAVR fully describes the axial dimension of scoliosis. Furthermore, the substitution of maxAVR for the apicalAVR should be especially avoided in double and triple curves, as the apical vertebra was even less commonly the most rotated in minor curves.

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Section: Discussionmentioning

confidence: 65%

Section: Introductionmentioning

confidence: 96%

Maximal Axial Vertebral Rotation in Adolescent Idiopathic Scoliosis: Is the Apical Vertebra the Most Rotated?

József

Schlégl

Burkus

et al. 2020

Global Spine Journal

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“…Previous studies have found some abnormalities in sagittal spinal alignment such as decreased thoracic kyphosis and hypo-lordosis in patients with AIS (3,(7)(8)(9)(10). Vertebral rotation in thoracic curves forces the spinal column anterolaterally and vertebral migration in lumbar curves forces the spinal column posterolaterally (11). Considering the anatomical and biomechanical relationships among different parts of the body, it is expected that any spinal malalignment in sagittal plane cause some changes in other parts of the musculoskeletal system such as pelvis or lower extremities (12)(13)(14)(15)(16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

Spinopelvic Sagittal Alignment in Patients With Adolescent Idiopathic Scoliosis

et al. 2015

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Background:Recently, several authors have demonstrated the importance of sagittal spinopelvic alignment in patients with adolescent idiopathic scoliosis (AIS). Objectives: In the current study, we investigated the preoperative spinal and pelvic sagittal parameters in the abovementioned patients. Patients and Methods: There were 50 consecutive patients with AIS (16 males and 34 females) in the current prospective study. In addition to the measurement of main scoliotic curve on posteroanterior X-rays, pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), and thoracic kyphosis (TK) were measured on lateral X-rays. Finally, the correlations between these parameters were investigated. We also compared the sagittal parameters between patients with main thoracic scoliosis (Lenke type I) and thoracolumbar/lumbar scoliosis (Lenke type V). Results: Main scoliotic curve (MSC) was correlated with TK and PT. LL was correlated positively with PI and SS. Negative correlation was found between SS and PI. The sagittal parameters were the same in patients with Lenke type I and Lenke type V scoliosis. In addition, MSC and LL were significantly greater in patients with thoracolumbar/lumbar scoliosis, while TK was significantly greater in patients with main thoracic scoliosis. In the main thoracic group, MSC and TK were positively and PI was negatively correlated with PT. LL and SS had a positive correlation. Conclusions: PI has a constant magnitude and is correlated with SS and LL. Postoperatively, pelvis can compensate for any change in LL. Therefore, the LL within fusion must be imposed in lordosis to the extent that the below fusion segments can compensate for intrafusion hypo/hyper lordosis to prevent the pelvis to compensate for hypo/hyper lordosis. This can result in a normal or near normal postoperative sagittal alignment. The authors recommend the surgeons to perform exact preoperative planning including the sagittal alignment of the pelvis in addition to spinal alignment.

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“…Our objective was to prove the relationship between shape of back (pelvic incidence) (PI) and parameters, which evaluate the kyphosis deformity in thoraco-lumbar trauma. Pelvic parameters defined for many years by Duval-Beaupère and legaye [17,18] are significant chain of correlations between positional pelvic and spinal parameters which are fundamental for the surgical management of spinal degenerative and malformative deformities [19][20][21]. Although, this concept is less spread in thoraco-lumbar fractures.…”

Section: Introductionmentioning

confidence: 99%

Influence of the Shape of Back on the Thoraco-lumbar Fractures

Trigui¹

2015

J Spine

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Introduction: The surgical management of degenerative and malformative spinal deformities takes into account the pelvic and spinal parameters. This concept is not applied in traumatology. Purpose: To adapt the correction of traumatic kyphosis deformity to the type of backs in function of pelvic incidence and to study the influence of the shape of backs on the localization, the type of fracture, the correction, and the loss at follow-up. Methods: It is a prospective study of 80 patients operated from February 2005 to December 2010. Mean folloupup was 52 months (18-72). Patients were treated by the same surgeon by a posterior osteosynthesis using in situ contouring technique. We evaluated kyphosis deformity according the shape of backs assessed by the value of the pelvic incidence (PI) calculated in lying position. Results: Our patients were classified with low PI (type 1, 2) in 35% of cases and high PI (type 3, 4) in 57% of cases. No significant difference was found in the repartition of fracture levels, type of fracture and the kyphosis deformity. However, the number of patients with good correction and with loss at follow-up was important in high pelvic incidence (p<0.001). Discussion: Neurologic status is not the only point of decision in chirurgical treatment. The kyphosis deformity in trauma is also an important point, but this angle is not always easy to measure. The relationship between deformities with injury level of spine depends on type of backs. A patient with trauma (lying position), pelvic incidence is the only angle which gives an idea about the shape of backs. According to Roussouly's classification, type 1 (long thoracolumbar kyphosis) and type 2 (flat), the correlation at the injury level is not necessary, but for type 3 and 4 (with harmony curvature), the correlation seems logical.

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Sagittal balance correction of idiopathic scoliosis using the in situ contouring technique

Cited by 14 publications

References 27 publications

Maximal Axial Vertebral Rotation in Adolescent Idiopathic Scoliosis: Is the Apical Vertebra the Most Rotated?

Maximal Axial Vertebral Rotation in Adolescent Idiopathic Scoliosis: Is the Apical Vertebra the Most Rotated?

Spinopelvic Sagittal Alignment in Patients With Adolescent Idiopathic Scoliosis

Influence of the Shape of Back on the Thoraco-lumbar Fractures

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