Differential rod contouring on thoracolumbar/lumbar curvature in patients with adolescent idiopathic scoliosis: An analysis with intraoperative acquisition of three-dimensional imaging |
| |
| Institution: | 1. Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, Toyama, 930-0194, Japan;2. Department of Orthopaedic Surgery, Takaoka City Hospital, Toyama, 933-8550, Japan;3. Department of Orthopaedic Surgery, Toyama Rosai Hospital, 662 Rokuromaru, Uozu, Toyama, 937-0042, Japan;4. Department of Orthopedic Surgery, Niigata University Medicine and Dental General Hospital, 1–754 Asahimachidori, Chuo Ward, Niigata, 951–8520 Japan;5. Department of Orthopaedic Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan;1. Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan;2. Department of Orthopaedic Surgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan;3. Department of Diagnostic Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan;4. Department of Environmental and Occupational Health, Department of Social Medicine, Faculty of Medicine, Toho University, 5-21-16 Ohmorinishi, Ohta, Tokyo, 143-8540, Japan;5. Department of Orthopaedic Surgery, Isehara Kyodo Hospital, 345 Tanaka, Isehara, Kanagawa, 259-1187, Japan;6. Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan;7. Department of Orthopaedic Surgery, Spine Center, Sanokousei General Hospital, 1728 Horigome, Sano, Tochigi, 327-8511, Japan;1. Department of Rehabilitation, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Matsushima 288, Kurashiki, Okayama, 701-0193, Japan;2. School of Health Science, Faculty of Medicine, Tottori University, Nishicho 86, Yonago, Tottori, 683-8503, Japan;3. Department of Orthopedic Surgery, Faculty of Medicine, Tottori University, Nishicho 36-1, Yonago, Tottori, 683- 8504, Japan;1. Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan;2. Department of Orthopaedic Surgery, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Japan;3. Department of Rehabilitation, Kansai University of Welfare Science, Osaka, Japan;1. Department of Neurosurgery, The Jikei University Hospital, Tokyo, Japan;2. Department of Radiology, The Jikei University Hospital, Tokyo, Japan;3. Siemens Healthcare K.K., AT Innovation Department, Tokyo, Japan |
| |
| Abstract: | BackgroundDifferential rod contouring (DRC) is useful for periapical vertebral derotation and decreasing rib hump in patients with thoracic adolescent idiopathic scoliosis (AIS). However, it is unknown whether DRC in the thoracolumbar/lumbar spine also contributes to derotation. We assessed the contributions of rod contouring and of DRC to the reduction of apical axial vertebral body rotation in patients with AIS with thoracolumbar/lumbar curvatures.MethodsForty-five (Lenke type 3 or 4, 17; Lenke type 5 or 6, 28) were analyzed for the contribution of DRC to thoracolumbar/lumbar spinal derotation. Rod contouring was assessed by comparing the preinsertion x-ray with the post-operative CT images. Intraoperative C-arm fluoroscopic scans of the periapical vertebrae of the thoracolumbar/lumbar curve of the scoliosis (135 vertebrae) were taken post-rod rotation (RR) and post-DRC in all patients. Three-dimensional images were automatically reconstructed from the taken x-ray images. The angle of vertebral body rotation in these apical vertebrae was measured, and the contribution of DRC to apical vertebral body derotation and rib hump index (RHi) for lumbar prominence was analyzed.ResultsThe pre-implantation convex rod curvatures of both Lenke 3/4 and 5/6 groups decreased after surgery. The mean further reductions in vertebral rotation with post-RR DRC were 3.7° for Lenke 3/4 and 4.4° for Lenke 5/6 (P < 0.01). Both changes in apical vertebral rotation and in RHi for evaluating lumbar prominence were significantly correlated with the difference between concave and convex rod curvature in preimplantation. Vertebral derotation was significantly higher in curves with a difference >20° (P < 0.05).ConclusionsDRC following rod rotation contributed substantial additional benefit to reducing vertebral rotation and decreasing lumbar prominence in thoracolumbar/lumbar scoliosis. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
