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Defining the Post-Operative Progression of Degenerative Scoliosis: An Analysis of Cases without Instrument Failure.
Jha, Rohan; Chalif, Joshua I; Yearley, Alexander G; Chalif, Eric; Zaidi, Hasan A.
Afiliação
  • Jha R; Harvard Medical School, Boston, MA 02115, USA; Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA 02115, USA.
  • Chalif JI; Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA 02115, USA.
  • Yearley AG; Harvard Medical School, Boston, MA 02115, USA; Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA 02115, USA.
  • Chalif E; Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA 02115, USA.
  • Zaidi HA; Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA 02115, USA. Electronic address: hzaidi1@bwh.harvard.edu.
J Clin Neurosci ; 120: 107-114, 2024 Feb.
Article em En | MEDLINE | ID: mdl-38237488
ABSTRACT

OBJECTIVE:

The expected post-operative changes in radiographic alignment over time remain poorly defined in patients surgically treated for degenerative scoliosis without instrument failure. Here we aim to describe the optimal natural progression of radiographic degenerative scoliosis at multiple timepoints in patients treated with a transforaminal lumbar interbody fusion (TLIF).

METHODS:

We identified an initial retrospective cohort of 114 patients treated with a TLIF for degenerative scoliosis between 2018 and 2022, with 39 patients ultimately meeting the imaging inclusion criteria. Patients who completed a primary or revision procedure with no evidence of instrument failure, proximal junctional kyphosis, or proximal junctional failure at last follow-up were included. Radiographic measurements of spinopelvic alignment were manually extracted from X-Ray scoliosis films.

RESULTS:

Thirty-nine patients (mean age 62.6 ± 8.7, mean follow-up 2.9 years), of which 23 underwent a primary TLIF (Primary) and 16 a revision procedure (Revision), were analyzed. Patients in the Primary group experienced a durable improvement in Thoracolumbar Cobb angle (-25° ± 15°), Thoracic Kyphosis (10° ± 13°), and Pelvic Incidence/lumbar lordosis mismatch (PI/LL) (-19° ± 19°) through the first year of follow-up. In the Revision group, at one year follow-up, all measures of spinopelvic alignment except PI/LL mismatch had reverted to pre-operative levels. Thoracolumbar Cobb angle decreased to a significantly greater degree in the Primary group compared to the Revision group.

CONCLUSION:

Primary TLIF operations without instrument failure consistently improve radiographic outcomes in three key measures through the first year. For revision procedures, there appears to be modest radiographic benefit at follow-up.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Escoliose / Fusão Vertebral / Cifose / Lordose Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Animals / Humans / Middle aged Idioma: En Revista: J Clin Neurosci Assunto da revista: NEUROLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Escoliose / Fusão Vertebral / Cifose / Lordose Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Animals / Humans / Middle aged Idioma: En Revista: J Clin Neurosci Assunto da revista: NEUROLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos