• Spine · Jun 2008

    Comparative Study

    Restoration of thoracic kyphosis by posterior instrumentation in adolescent idiopathic scoliosis: comparative radiographic analysis of two methods of reduction.

    • Jean-Luc Clement, Edouard Chau, Charles Kimkpe, and Marie-Jose Vallade.
    • Department of Pediatric Orthopaedic Surgery and Scoliosis Surgery, Hospital Lenval, Nice, France. jean-luc.clement@lenval.com
    • Spine. 2008 Jun 15;33(14):1579-87.

    Study DesignA retrospective comparison of radiographic results for 2 consecutive series of patients treated for adolescent idiopathic scoliosis (AIS) by posterior instrumentations with thoracic screws using 2 methods of reduction: sequential approximation by cantilever reduction (CR) and simultaneous translation technique on 2 rods (ST2R).ObjectiveTo compare correction of thoracic hypokyphosis and coronal radiographic results between the 2 methods of reduction.Summary Of Background DataPublications concerning AIS confirm the moderate correction of thoracic hypokyphosis by posterior instrumentation with hooks and also with pedicle screws.MethodsForty-four patients with AIS (Lenke type 1, 2, 3) underwent a posterior spinal fusion and instrumentation (CR series: 21 patients--ST2R series: 23 patients). Three groups of preoperative kyphosis were generated: 12 patients with severe hypokyphosis (20 degrees ) (11 and 9 patients, respectively). Thoracic kyphosis (T4-T12) and Cobb angle measurements of major and minor curves were evaluated by an independent observer. The minimum follow-up was 2 years.ResultsAt final follow-up, regarding patients with a severe preoperative hypokyphosis, the mean gain was 14 degrees in the CR series (8 degrees preoperative-22 degrees postoperative) and 27 degrees in the ST2R series (3-30 degrees ) (P = 0.018). Concerning patients with mild hypokyphosis, the mean gains were, respectively, 8 degrees (17-25 degrees ) and 18 degrees (16-34 degrees ) (P = 0.052). After surgery, 3 patients of CR series had hypokyphosis whereas the patients of the ST2R series all had normal kyphosis. In coronal plane, the mean correction of scoliosis was similar for both groups (75% vs. 69%; P = 0.177).ConclusionSimultaneous translation on 2 rods provides a better correction of thoracic kyphosis than the sequential approximation by CR on patients with preoperative hypokyphosis. This surgical technique restores normal thoracic kyphosis in all cases.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…