Association of coronal balance reconstruction of unfused segments after posterior selective fusion for thoracolumbar and lumbar idiopathic scoliosis
10.3760/cma.j.issn.0253-2352.2014.04.002
- VernacularTitle:胸腰段或腰段特发性脊柱侧凸选择性后路融合术后未融合节段在冠状面平衡重建中的作用
- Author:
Zhijian SUN
;
Guixing QIU
;
Yu ZHAO
;
Yipeng WANG
;
Jianxiong SHEN
;
Jianguo ZHANG
;
Hong ZHAO
- Publication Type:Journal Article
- Keywords:
Thoracic vertebrae;
Lumbar vertebrae;
Scoliosis;
Spinal fusion
- From:
Chinese Journal of Orthopaedics
2014;34(4):355-360
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the relationship between reconstruction of coronal trunk shift and changes of unfused segments after selective posterior thoracolumbar/lumbar curves fusion for idiopathic scoliosis.Methods Radiographic data of patients with thoracolumbar/lumbar idiopathic scoliosis who underwent selective posterior correction at our hospital from October 2005 to October 2011 with a minimum of 2 year follow-up period was retrospectively analyzed.Posteroanterior and lateral radiographs of the whole spine before surgery,after surgery and at the last follow-up were performed.Changes of coronal trunk shift during follow-up period were observed and multiple linear regression analysis was performed to determine its relationship with changes of upper thoracic curve,main thoracic curve,lumbar curve,distal unfused segments and coronal sacral inclination.Results Thirty-seven patients with 4 males and 33 females were included in this study.The average age was 14.6±2.0 years (range,12-20 years).The mean follow-up period was 3.6 years (range,2-8.9 years).The mean preoperative Cobb angles of lumbar and thoracic curve were 44.2° and 25.2°,respectively.At the last follow-up,they were corrected to 10.3° and 13.6°,indicating 75.7％ and 44.9％ correction rate,respectively.The pre-and post-operative mean trunk shifts were 2.2 cm and 2.0 cm with no significant differences.At the last follow-up,it compensated to 0.9 cm,which showed significant differences compared with that of postoperation.Linear regression analysis suggested that trunk shift changes during follow-up period were only correlated with changes of distal unfused segments.The regression equation could be described as Changes of trunk shift (cm) =1.248 7+0.137 8×Changes of distal unfused segments (°).Conclusion The reconstruction of coronal trunk balance is mainly compensated by distal unfused segments after selective posterior correction for thoracolumbar/lumbar idiopathic scoliosis.Although preserved most of its levels,unfused thoracic segments do not play an important role in the reconstruction of trunk shift.
