[Change of cervical sagittal alignment after the treatment of growing rods to the early-onset scoliosis].
Zhonghua Yi Xue Za Zhi
; 100(13): 983-990, 2020 Apr 07.
Article
em Zh
| MEDLINE
| ID: mdl-32294854
ABSTRACT
Objective:
To determine the impact of growing rods (GR) technique on cervical alignment in early-onset scoliosis (EOS) through the change of cervical alignment parameters after the GR surgery.Methods:
Total of 24 consecutive EOS patients treated in Beijing Chao-Yang Hospital from 2009 to 2018 were retrospectively reviewed (17 males and 7 females). Cervical lordosis, T(1) slope and C(2-7) sagittal vertical axis (C(2-7)SVA), thoracic/lumbar Cobb angle, thoracic kyphosis (TK), global kyphosis Cobb angle, SVA were included in radiographic data in the full spinal standing X-ray before and post operation and at the last follow-up. Based on clinical data, including the upper instrumented vertebra (UIV), proximal junctional kyphosis (PJK) and the number of GR, patients were divided into different groups for statistical analysis. Logistic regression analysis was used to find the independent risk factors of the abnormality of C(2-7)SVA.Results:
All patients received at least one time of distraction operation, the mean follow-up was (35±14) months. The C(2-7) Cobb angle increased from 17°±11° to 18°±9° and T(1) slope changed from 28°±13° to 28°±11° and C(2-7)SVA changed from (17±11) mm to (16±10) mm after the operation, but no significant differences were found in those indexes before and after the operation (t=-1.15, 0.14, 0.55, all P>0.05). At the last follow-up after GR technique, the C(2-7) Cobb angle, T(1) slope angle and C(2-7)SVA significantly increased when compared with those before the operation (t=-7.60, -4.08, -2.46, all P<0.05). The â³C(2-7) Cobb angle and â³T(1) slope angle PJK group was both more significant than those in non-PJK group (t=3.50, 3.25, both P<0.05); while there was no significant difference in the â³C(2-7) Cobb angle and â³T(1) slope angle when the choice of UIV and the number of GD were taken into account (t=-1.02, -1.61, -0.67, 0.31, all P>0.05). The occurrence of PJK was identified as an independent risk factor for the abnormality of C(2-7)SVA during the GR surgery with logistic regression analysis(OR=11.57, 95%CI 1.49-91.54, P<0.05).Conclusions:
When used for EOS to correct deformity, GR surgery will increase the cervical lordosis and T(1) slope angle of EOS patients. More attention should be paid to the cervical sagittal alignment and cervical sagittal imbalance in EOS patients with PJK.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Escoliose
/
Fusão Vertebral
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Male
Idioma:
Zh
Revista:
Zhonghua Yi Xue Za Zhi
Ano de publicação:
2020
Tipo de documento:
Article