Idiopathic adolescent scoliosis, post-operative analysis. Case Series
DOI:
https://doi.org/10.1016/j.rccot.2021.04.002Keywords:
scoliosis, spine abnormalities, spine fusion, surgery, outcomeAbstract
Background: Scoliosis is a three-dimensional deformity of the spine. The main objective of treatment is to avoid progression, achieve maximum correction and arthrodesis of the least number of segments, with good coronal and sagittal balance that allows a painless fusion. The aim of the study is to evaluate the results of patients who underwent to surgical fusion for adolescent idiopathic scoliosis.
Material and Methods: A case series study was conducted by analyzing medical records of patients who underwent to surgical fusion for adolescent idiopathic scoliosis. between 2011 through 2017.An analysis of demographic data, the type of curve, the density of screws used, the percentage of reduction achieved after one year, and complications was performed.
Results: Data of 27 patients was included. Lenke 1B curves were predominant. The mean preoperative Cobb angle was 66.5o with a postoperative 24.4o. Screw density presented an average of 1.4. Complications were presented in 25.6% of the patients, the most frequent being infection. Good results were obtained in the SRS-22 questionnaire.
Discussion: A density of 0.8-1.69 screws per fused vertebra has been reported with a correction percentage of 64-70%. In our results, the density of screws per fused vertebra was 1.4, achieving a reduction of 64.1%. Increasing the number of screws did not increase the degree of correction of the curves. In accordance with the literature, the most frequent complication was infection, with a low incidence of neurological injury. We conclude that the arthrodesis technique used in our center, with third-generation pedicle screws, obtains good reduction results, with a percentage of complications similar to those previously reported.
Downloads
References
Steven R. Garfin MD, Frank J. Eismont MD, Gordon R. Bell MD, Jeffrey S. Fischgrund MD yChristopher M. Bono MD. Rothman- Simeone and Herkowitzs, The Spine, 7ta edición, Elsevier, Capítulo 27, 451-468.
Oda M, Rauh S, Gregory P, Silverman F, Bleck E. The significance of ro ent genographic measurement in scoliosis. J Pediatr Orthop B. 1982;24:378-82. https://doi.org/10.1097/01241398-198210000-00005
Harrison D, Harrison D, Cailliet R, Jadik T, Holland B. Radiographic analysis of lumbar lordosis: Centroid, Cobb TRALL and Harrison posterior tangent methods. Spine. 2001;26:E235-42. https://doi.org/10.1097/00007632-200106010-00003
Lenke LG, Betz RR, Harms J, Bridwell KH, Clements DH, Lowe TG. Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis. Journal of Bone Joint and Surgery. 2001;83-A:1169-81. https://doi.org/10.2106/00004623-200108000-00006
Lenke LG. The Lenke Classification System of Operative Adolescent Idiopathic Scoliosis. Neurosurg Clin N Am. 2007;18:199-206. https://doi.org/10.1016/j.nec.2007.02.006
Groiso JA. Patología ortopédica. En: Sociedad Argentina de Pediatría, editor. Atención integral de adolescentes y jóvenes. Criterios de diagnóstico y tratamiento. Volumen 2. Buenos Aires: Sociedad Argentina de Pediatría; 1996. p. 305-18.
Bueche MJ. Scoliosis and kyphosis. En: Neinstein LS, Gordon CM, Katzman DK, Rosen D, et al, editores. Adolescent Health Care: a practical guide. 5th ed Philadelphia: Lippincott Williams & Wilkins; 2007. p. 235-42.
Altaf F, Gibson A, Dannawi Z, Noordeen H. Adolescent idiopathic scoliosis Clinical Review BMJ. 2013;346:f2508.https://doi.org/10.1136/bmj.f2508
Hibbs RA. A report of fifty nine cases of scoliosis treated by the fusion operation By Russell A. Hibbs, 1924. Clin Orthop Relat Res. 1988:4-19. https://doi.org/10.1097/00003086-198804000-00002
Harrington PR. Treatment of scoliosis: correction and internal fixation by spine instrumentation. June 1962. J Bone Joint Surg. 2002;84-A:316. https://doi.org/10.2106/00004623-200202000-00020
Cotrel Y, Dobousset J, Guillaumat M. New universal instrumentation in spinal surgery. Clin Orthop Rel Res. 1988;227:10-23. https://doi.org/10.1097/00003086-198802000-00004
Lea Plaza C. The Lea-Plaza frame for scoliosis. Orthop Clin North Am. 1994;25:321-31. https://doi.org/10.1016/S0030-5898(20)31913-1
Karsaclian M, Cuneo A, Rodriguez S, Schimchak M, Wodowóz O, Alvarez I. Corrección instrumentada de la escoliosis idiopática del adolescente y artrodesis con aloinjerto de banco. Revista médica del Uruguay. 2007;23:351-9.
Tannous OO, Banagan KE, Belin EJ, Jazini E, Weir TB, Ludwig SC, Gelb DE. Low- Density Pedicle Screw Constructs for Adolescent Idiopathic Scoliosis: Evaluation of Effectiveness and Cost. Global Spine Journal. 2018;8:114-20. https://doi.org/10.1177/2192568217735507
Shen M, Jiang H, Luo M, Wang W, Li N, Wang L. Comparison of low density and high density pedicle screw instrumentation in Lenke 1 adolescent idiopathic scoliosis; Shen et al. BMC Musculoskeletal Disorders. 2017;18:336. https://doi.org/10.1186/s12891-017-1695-x
Larson AN, Aubin CE, Polly DW Jr, Ledonio CG, Lonner BS, Shah SA, Erickson MA, Emans JB, Weinstein SL. Are More Screws Better? A Systematic Review of Anchor Density and Curve Correction in Adolescent Idiopathic Scoliosis. Spine Deformity. 2013;1:237-47. https://doi.org/10.1016/j.jspd.2013.05.009
Haher TR, Gorup JM, Shin TM, Homel P, Merola AA, Grogan DP, et al. Results of the Scoliosis Research Society instrument for evaluation of surgical outcome in adolescent idiopathic scoliosis. A multicenter study of 244 patients. Spine. 1999;24:1435-40. https://doi.org/10.1097/00007632-199907150-00008
Asher MA, Lai SM, Glattes RC, Burton DC, Alanay A, Bago J. Refinement of the SRS-22 Health-Related Quality of Life questionnaire Function domain. Spine. 2006;31:593-7. https://doi.org/10.1097/01.brs.0000201331.50597.ea
Lenke LG, Betz RR, Clements D, Merola A, Haher T, Lowe T, Blanke K. Curve Prevalence of a New Classification of Operative Adolescent Idiopathic Scoliosis. Spine. 2002;27:604-11. https://doi.org/10.1097/00007632-200203150-00008
Marios G, Lykissas, Alvin H, Crawford, Viral V. Jain. Complications of Surgical Treatment of Pediatric Spinal Deformities. Orthop Clin North Am. 2013;44:357-70. https://doi.org/10.1016/j.ocl.2013.03.007
Murphy R, Mooney J. Complications following spine fusion for adolescent idiopathic scoliosis. Curr Rev Musculoskelet. 2016;9:462-9. https://doi.org/10.1007/s12178-016-9372-5
Climent J, Bagó J, Rodríguez-Ruiz C, Sánchez-Rayac J, Mulet A, Cholbi F. Nueva estrategia para mejorar la medida de la calidad de vida en la escoliosis idiopática: adición de la dimensión de deformidad percibida al cuestionario de la Scoliosis Research Society (SRS-22). Rehabilitación. 2011;45:228-32. https://doi.org/10.1016/j.rh.2011.04.007
Climent J, Bago J, Ey A, Perez-Grueso F, Izquierdo E. Validity of the Spanish Version of the Scoliosis Research Society- 22 (SRS-22) Patient Questionnaire. Spine. 2005;30:705-9, https://doi.org/10.1097/01.brs.0000155408.76606.8f
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 3.0 Unported License.
Derechos de autor
Los autores aceptar transferir a la Revista Colombiana de Ortopedia y Traumatología los derechos edición, publicación y reproducción de los artículos publicados. La editorial tiene el derecho del uso, reproducción, transmisión, distribución y publicación en cualquier forma o medio. Los autores no podrán permitir o autorizar el uso de la contribución sin el consentimiento escrito de la revista. Una vez firmada por todos los autores, la carta de Cesión de derechos debe ser cargada en el paso dos del envío.
Aquellos autores que tengan publicaciones en esta revista aceptan los siguientes términos:
- Los autores/as conservarán sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia de reconocimiento de Creative Commons que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación esta revista.
- Los autores/as podrán adoptar otros acuerdos de licencia no exclusiva de distribución de la versión de la obra publicada (p. ej.: depositarla en un archivo telemático institucional o publicarla en un volumen monográfico) siempre que se indique la publicación inicial en esta revista.
- Se permite y recomienda a los autores/as difundir su obra a través de Internet (p. ej.: en archivos telemáticos institucionales o en su página web), lo cual puede producir intercambios interesantes y aumentar las citas de la obra publicada. (Véase El efecto del acceso abierto).
