Choice of Lowest Instrumented Vertebras for Lenke I Adolescent Idiopathic Scoliosis Orthopedics

Zhisheng Ji; Sida Chen; Guowei Zhang; Yuhao Yang; Yaozhong Liang; Hongsheng Lin

doi:doi:10.11648/j.js.20160406.13

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Choice of Lowest Instrumented Vertebras for Lenke I Adolescent Idiopathic Scoliosis Orthopedics

Zhisheng Ji, Sida Chen, Guowei Zhang, Yuhao Yang, Yaozhong Liang, Hongsheng Lin

Published in Journal of Surgery (Volume 4, Issue 6)

Received: 22 December 2016 Accepted: 30 December 2016 Published: 21 January 2017

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Abstract

To discuss the impact of different lowest instrumented vertebras on the effect of posterior spinal pedicle screw-rod orthopedics for treatment of Lenke I adolescent idiopathic scoliosis. 45 patients with adolescent idiopathic scoliosis (AIS) who received posterior pedicle screw-rod orthopedics from July 2011 to September 2015 were analyzed retrospectively. All patients were divided into touched vertebra group (n=21 cases; 6 M and 15 F) and stable vertebra group (n=24 cases; 7 M and 17 F) according to the choice of different lowest instrumented vertebras. The indexes of the coronal and sagittal spinal imaging before and after operation as well as in the last follow-up were analyzed and SRS-22 questionnaire was performed to evaluate the curative effect. Through a 6-36-month follow-up visit, no significant difference was found in the pre-operative indexes (Cobb angle and pre-operative TS, SVA, TK and LL) of the coronal and sagittal spinal imaging between the two groups (P>0.05). Meanwhile, there was no statistical difference in the spinal coronal parameters (i.e., Cobb angle, TS, pre-operative thoracic-waist/waist scoliosis, pre-operative flexibility of thoracic scoliosis, correction rate and loss rate) after operation and in the last follow-up visit between the two groups (P>0.05). In touched vertebra group, the coronal spinal parameters (e.g., thoracic-waist/waist scoliosis) after operation and in the last follow-up visit were significantly higher than those of stable vertebra group (P<0.05) while there was no statistical difference in postoperative SVA between the two groups (P>0.05). In the aspect of fusion segments, the touched vertebra group saved one centrum relative to stable vertebra group (P<0.05). The postoperative SRS-22 scores for living quality of both groups were significantly decreased compared with the pre-operative, in which the score was decreased from the preoperative 51.0 to 29.0 in touched vertebra group and from 50.9 to 28.7 in stable vertebra group (both P<0.05), but both the pre- and post-operative scores were not significantly different between the two groups (P>0.05). In order to treat Lenke I AIS patients with posterior pedicle screw-rod orthopedics, touched vertebra should be used as lowest instrumented vertebra as it can not only obtain the similar therapeutic effect to stable vertebra, but also shorten the fixed segments.

Published in	Journal of Surgery (Volume 4, Issue 6)
DOI	10.11648/j.js.20160406.13
Page(s)	134-140
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2017. Published by Science Publishing Group

Keywords

Idiopathic Scoliosis, Lowest Instrumented Vertebra, Stable Vertebra, Touched Vertebra

References

[1]	Lenke, L. G., R. R. Betz, J. Harms, K. H. Bridwell, D. H. Clements, T. G. Lowe, and K. Blanke, Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis. J Bone Joint Surg Am, 2001, 83-A (8): 1169-81.
[2]	Weinstein, S. L., L. A. Dolan, J. C. Cheng, A. Danielsson, and J. A. Morcuende, Adolescent idiopathic scoliosis. Lancet, 2008, 371 (9623): 1527-37.
[3]	Korbel, K., M. Kozinoga, L. Stolinski, and T. Kotwicki, Scoliosis Research Society (SRS) Criteria and Society of Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) 2008 Guidelines in Non-Operative Treatment of Idiopathic Scoliosis. Pol Orthop Traumatol, 2014, 79: 118-22.
[4]	Parent, S., P. O. Newton, and D. R. Wenger, Adolescent idiopathic scoliosis: etiology, anatomy, natural history, and bracing. Instr Course Lect, 2005, 54: 529-36.
[5]	Asher, M. A. and D. C. Burton, Adolescent idiopathic scoliosis: natural history and long term treatment effects. Scoliosis, 2006, 1 (1): 2.
[6]	Kadoury, S., F. Cheriet, M. Beausejour, I. A. Stokes, S. Parent, and H. Labelle, A three-dimensional retrospective analysis of the evolution of spinal instrumentation for the correction of adolescent idiopathic scoliosis. Eur Spine J, 2009, 18 (1): 23-37.
[7]	Qin, X., W. Sun, L. Xu, Z. Liu, Y. Qiu, and Z. Zhu, Selecting the Last "Substantially" Touching Vertebra as Lowest Instrumented Vertebra in Lenke Type 1A Curve: Radiographic Outcomes With a Minimum of 2-year Follow-Up. Spine (Phila Pa 1976), 2016, 41 (12): E742-50.
[8]	Wang, Y., C. E. Bunger, Y. Zhang, and E. S. Hansen, Lowest instrumented vertebra selection in Lenke 3C and 6C scoliosis: what if we choose lumbar apical vertebra as distal fusion end? Eur Spine J, 2012, 21 (6): 1053-61.
[9]	Carreon, L. Y., C. H. Crawford, III, L. G. Lenke, D. J. Sucato, and S. D. Glassman, Optimal Lowest Instrumented Vertebra Selection for Posterior Instrumented Fusion of Lenke Type 5 and 6 Adolescent Idiopathic Scoliosis: Is There a Difference in Outcome Between L3 and L4? The Spine Journal, 13 (9): S38.
[10]	Salah, H., H. B. Elsebaie, and A. Ezz, Instrumenting Proximal to the Left Bending Stable Vertebra in Lenke IA and IB Adolescent Idiopathic Scoliosis Predicts Adding On: Poster #307. Spine Journal Meeting Abstracts, 2010:167.
[11]	Suk, S. I., J. H. Kim, S. S. Kim, J. J. Lee, and Y. T. Han, Thoracoplasty in thoracic adolescent idiopathic scoliosis. Spine (Phila Pa 1976), 2008, 33 (10): 1061-7.
[12]	Wang, Y., E. S. Hansen, K. Hoy, C. Wu, and C. E. Bunger, Distal adding-on phenomenon in Lenke 1A scoliosis: risk factor identification and treatment strategy comparison. Spine (Phila Pa 1976), 2011, 36 (14): 1113-22.
[13]	Cao, K., K. Watanabe, N. Kawakami, T. Tsuji, N. Hosogane, I. Yonezawa, M. Machida, M. Yagi, S. Kaneko, Y. Toyama, and M. Matsumoto, Selection of lower instrumented vertebra in treating Lenke type 2A adolescent idiopathic scoliosis. Spine (Phila Pa 1976), 2014, 39 (4): E253-61.

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APA Style

Zhisheng Ji, Sida Chen, Guowei Zhang, Yuhao Yang, Yaozhong Liang, et al. (2017). Choice of Lowest Instrumented Vertebras for Lenke I Adolescent Idiopathic Scoliosis Orthopedics. Journal of Surgery, 4(6), 134-140. https://doi.org/10.11648/j.js.20160406.13

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ACS Style

Zhisheng Ji; Sida Chen; Guowei Zhang; Yuhao Yang; Yaozhong Liang, et al. Choice of Lowest Instrumented Vertebras for Lenke I Adolescent Idiopathic Scoliosis Orthopedics. J. Surg. 2017, 4(6), 134-140. doi: 10.11648/j.js.20160406.13

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AMA Style

Zhisheng Ji, Sida Chen, Guowei Zhang, Yuhao Yang, Yaozhong Liang, et al. Choice of Lowest Instrumented Vertebras for Lenke I Adolescent Idiopathic Scoliosis Orthopedics. J Surg. 2017;4(6):134-140. doi: 10.11648/j.js.20160406.13

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@article{10.11648/j.js.20160406.13,
  author = {Zhisheng Ji and Sida Chen and Guowei Zhang and Yuhao Yang and Yaozhong Liang and Hongsheng Lin},
  title = {Choice of Lowest Instrumented Vertebras for Lenke I Adolescent Idiopathic Scoliosis Orthopedics},
  journal = {Journal of Surgery},
  volume = {4},
  number = {6},
  pages = {134-140},
  doi = {10.11648/j.js.20160406.13},
  url = {https://doi.org/10.11648/j.js.20160406.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20160406.13},
  abstract = {To discuss the impact of different lowest instrumented vertebras on the effect of posterior spinal pedicle screw-rod orthopedics for treatment of Lenke I adolescent idiopathic scoliosis. 45 patients with adolescent idiopathic scoliosis (AIS) who received posterior pedicle screw-rod orthopedics from July 2011 to September 2015 were analyzed retrospectively. All patients were divided into touched vertebra group (n=21 cases; 6 M and 15 F) and stable vertebra group (n=24 cases; 7 M and 17 F) according to the choice of different lowest instrumented vertebras. The indexes of the coronal and sagittal spinal imaging before and after operation as well as in the last follow-up were analyzed and SRS-22 questionnaire was performed to evaluate the curative effect. Through a 6-36-month follow-up visit, no significant difference was found in the pre-operative indexes (Cobb angle and pre-operative TS, SVA, TK and LL) of the coronal and sagittal spinal imaging between the two groups (P>0.05). Meanwhile, there was no statistical difference in the spinal coronal parameters (i.e., Cobb angle, TS, pre-operative thoracic-waist/waist scoliosis, pre-operative flexibility of thoracic scoliosis, correction rate and loss rate) after operation and in the last follow-up visit between the two groups (P>0.05). In touched vertebra group, the coronal spinal parameters (e.g., thoracic-waist/waist scoliosis) after operation and in the last follow-up visit were significantly higher than those of stable vertebra group (PP>0.05). In the aspect of fusion segments, the touched vertebra group saved one centrum relative to stable vertebra group (PPP>0.05). In order to treat Lenke I AIS patients with posterior pedicle screw-rod orthopedics, touched vertebra should be used as lowest instrumented vertebra as it can not only obtain the similar therapeutic effect to stable vertebra, but also shorten the fixed segments.},
 year = {2017}
}

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TY  - JOUR
T1  - Choice of Lowest Instrumented Vertebras for Lenke I Adolescent Idiopathic Scoliosis Orthopedics
AU  - Zhisheng Ji
AU  - Sida Chen
AU  - Guowei Zhang
AU  - Yuhao Yang
AU  - Yaozhong Liang
AU  - Hongsheng Lin
Y1  - 2017/01/21
PY  - 2017
N1  - https://doi.org/10.11648/j.js.20160406.13
DO  - 10.11648/j.js.20160406.13
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 134
EP  - 140
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20160406.13
AB  - To discuss the impact of different lowest instrumented vertebras on the effect of posterior spinal pedicle screw-rod orthopedics for treatment of Lenke I adolescent idiopathic scoliosis. 45 patients with adolescent idiopathic scoliosis (AIS) who received posterior pedicle screw-rod orthopedics from July 2011 to September 2015 were analyzed retrospectively. All patients were divided into touched vertebra group (n=21 cases; 6 M and 15 F) and stable vertebra group (n=24 cases; 7 M and 17 F) according to the choice of different lowest instrumented vertebras. The indexes of the coronal and sagittal spinal imaging before and after operation as well as in the last follow-up were analyzed and SRS-22 questionnaire was performed to evaluate the curative effect. Through a 6-36-month follow-up visit, no significant difference was found in the pre-operative indexes (Cobb angle and pre-operative TS, SVA, TK and LL) of the coronal and sagittal spinal imaging between the two groups (P>0.05). Meanwhile, there was no statistical difference in the spinal coronal parameters (i.e., Cobb angle, TS, pre-operative thoracic-waist/waist scoliosis, pre-operative flexibility of thoracic scoliosis, correction rate and loss rate) after operation and in the last follow-up visit between the two groups (P>0.05). In touched vertebra group, the coronal spinal parameters (e.g., thoracic-waist/waist scoliosis) after operation and in the last follow-up visit were significantly higher than those of stable vertebra group (PP>0.05). In the aspect of fusion segments, the touched vertebra group saved one centrum relative to stable vertebra group (PPP>0.05). In order to treat Lenke I AIS patients with posterior pedicle screw-rod orthopedics, touched vertebra should be used as lowest instrumented vertebra as it can not only obtain the similar therapeutic effect to stable vertebra, but also shorten the fixed segments.
VL  - 4
IS  - 6
ER  -

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Author Information

Zhisheng Ji

Department of Orthopedics, the First Affiliated Hospital of Jinan University, Guangzhou, China
Sida Chen

Department of Orthopedics, the First Affiliated Hospital of Jinan University, Guangzhou, China
Guowei Zhang

Department of Orthopedics, the First Affiliated Hospital of Jinan University, Guangzhou, China
Yuhao Yang

Department of Orthopedics, the First Affiliated Hospital of Jinan University, Guangzhou, China
Yaozhong Liang

Department of Orthopedics, the First Affiliated Hospital of Jinan University, Guangzhou, China
Hongsheng Lin

Department of Orthopedics, the First Affiliated Hospital of Jinan University, Guangzhou, China

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Plain Text BibTeX RIS

APA Style

Zhisheng Ji, Sida Chen, Guowei Zhang, Yuhao Yang, Yaozhong Liang, et al. (2017). Choice of Lowest Instrumented Vertebras for Lenke I Adolescent Idiopathic Scoliosis Orthopedics. Journal of Surgery, 4(6), 134-140. https://doi.org/10.11648/j.js.20160406.13

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ACS Style

Zhisheng Ji; Sida Chen; Guowei Zhang; Yuhao Yang; Yaozhong Liang, et al. Choice of Lowest Instrumented Vertebras for Lenke I Adolescent Idiopathic Scoliosis Orthopedics. J. Surg. 2017, 4(6), 134-140. doi: 10.11648/j.js.20160406.13

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AMA Style

Zhisheng Ji, Sida Chen, Guowei Zhang, Yuhao Yang, Yaozhong Liang, et al. Choice of Lowest Instrumented Vertebras for Lenke I Adolescent Idiopathic Scoliosis Orthopedics. J Surg. 2017;4(6):134-140. doi: 10.11648/j.js.20160406.13

Copy | Download

@article{10.11648/j.js.20160406.13,
  author = {Zhisheng Ji and Sida Chen and Guowei Zhang and Yuhao Yang and Yaozhong Liang and Hongsheng Lin},
  title = {Choice of Lowest Instrumented Vertebras for Lenke I Adolescent Idiopathic Scoliosis Orthopedics},
  journal = {Journal of Surgery},
  volume = {4},
  number = {6},
  pages = {134-140},
  doi = {10.11648/j.js.20160406.13},
  url = {https://doi.org/10.11648/j.js.20160406.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20160406.13},
  abstract = {To discuss the impact of different lowest instrumented vertebras on the effect of posterior spinal pedicle screw-rod orthopedics for treatment of Lenke I adolescent idiopathic scoliosis. 45 patients with adolescent idiopathic scoliosis (AIS) who received posterior pedicle screw-rod orthopedics from July 2011 to September 2015 were analyzed retrospectively. All patients were divided into touched vertebra group (n=21 cases; 6 M and 15 F) and stable vertebra group (n=24 cases; 7 M and 17 F) according to the choice of different lowest instrumented vertebras. The indexes of the coronal and sagittal spinal imaging before and after operation as well as in the last follow-up were analyzed and SRS-22 questionnaire was performed to evaluate the curative effect. Through a 6-36-month follow-up visit, no significant difference was found in the pre-operative indexes (Cobb angle and pre-operative TS, SVA, TK and LL) of the coronal and sagittal spinal imaging between the two groups (P>0.05). Meanwhile, there was no statistical difference in the spinal coronal parameters (i.e., Cobb angle, TS, pre-operative thoracic-waist/waist scoliosis, pre-operative flexibility of thoracic scoliosis, correction rate and loss rate) after operation and in the last follow-up visit between the two groups (P>0.05). In touched vertebra group, the coronal spinal parameters (e.g., thoracic-waist/waist scoliosis) after operation and in the last follow-up visit were significantly higher than those of stable vertebra group (PP>0.05). In the aspect of fusion segments, the touched vertebra group saved one centrum relative to stable vertebra group (PPP>0.05). In order to treat Lenke I AIS patients with posterior pedicle screw-rod orthopedics, touched vertebra should be used as lowest instrumented vertebra as it can not only obtain the similar therapeutic effect to stable vertebra, but also shorten the fixed segments.},
 year = {2017}
}

Copy | Download

TY  - JOUR
T1  - Choice of Lowest Instrumented Vertebras for Lenke I Adolescent Idiopathic Scoliosis Orthopedics
AU  - Zhisheng Ji
AU  - Sida Chen
AU  - Guowei Zhang
AU  - Yuhao Yang
AU  - Yaozhong Liang
AU  - Hongsheng Lin
Y1  - 2017/01/21
PY  - 2017
N1  - https://doi.org/10.11648/j.js.20160406.13
DO  - 10.11648/j.js.20160406.13
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 134
EP  - 140
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20160406.13
AB  - To discuss the impact of different lowest instrumented vertebras on the effect of posterior spinal pedicle screw-rod orthopedics for treatment of Lenke I adolescent idiopathic scoliosis. 45 patients with adolescent idiopathic scoliosis (AIS) who received posterior pedicle screw-rod orthopedics from July 2011 to September 2015 were analyzed retrospectively. All patients were divided into touched vertebra group (n=21 cases; 6 M and 15 F) and stable vertebra group (n=24 cases; 7 M and 17 F) according to the choice of different lowest instrumented vertebras. The indexes of the coronal and sagittal spinal imaging before and after operation as well as in the last follow-up were analyzed and SRS-22 questionnaire was performed to evaluate the curative effect. Through a 6-36-month follow-up visit, no significant difference was found in the pre-operative indexes (Cobb angle and pre-operative TS, SVA, TK and LL) of the coronal and sagittal spinal imaging between the two groups (P>0.05). Meanwhile, there was no statistical difference in the spinal coronal parameters (i.e., Cobb angle, TS, pre-operative thoracic-waist/waist scoliosis, pre-operative flexibility of thoracic scoliosis, correction rate and loss rate) after operation and in the last follow-up visit between the two groups (P>0.05). In touched vertebra group, the coronal spinal parameters (e.g., thoracic-waist/waist scoliosis) after operation and in the last follow-up visit were significantly higher than those of stable vertebra group (PP>0.05). In the aspect of fusion segments, the touched vertebra group saved one centrum relative to stable vertebra group (PPP>0.05). In order to treat Lenke I AIS patients with posterior pedicle screw-rod orthopedics, touched vertebra should be used as lowest instrumented vertebra as it can not only obtain the similar therapeutic effect to stable vertebra, but also shorten the fixed segments.
VL  - 4
IS  - 6
ER  -

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