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  1. Article ; Online: Neck and shoulder pain in thoracic adolescent idiopathic scoliosis 10 years after posterior spinal fusion.

    Ohashi, Masayuki / Watanabe, Kei / Hirano, Toru / Hasegawa, Kazuhiro / Tashi, Hideki / Makino, Tatsuo / Minato, Keitaro / Sato, Masayuki / Kawashima, Hiroyuki

    European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

    2024  

    Abstract: Purpose: We aimed to determine the clinical significance of neck and shoulder pain (NSP) 10 years after posterior spinal fusion (PSF) for thoracic adolescent idiopathic scoliosis (AIS) and the relationship between radiographic parameters and NSP.: ... ...

    Abstract Purpose: We aimed to determine the clinical significance of neck and shoulder pain (NSP) 10 years after posterior spinal fusion (PSF) for thoracic adolescent idiopathic scoliosis (AIS) and the relationship between radiographic parameters and NSP.
    Methods: Of 72 patients who underwent PSF for thoracic AIS (Lenke 1 or 2) between 2000 and 2013, we included 52 (46 females; Lenke type 1 in 34 patients and type 2 in 18; mean age, 25.6 years) who underwent NSP evaluation using visual analog scale (VAS, 10 cm) 10 years postoperatively (follow-up rate, 72.2%). Correlation analyses were performed using Spearman's rank correlation coefficient (r).
    Results: The VAS for NSP was 2.6 cm in median and 3.4 cm in mean at 10 years. The VAS had significant negative correlations with several SRS-22 domain scores (rs = - 0.348 for pain, - 0.347 for function,  -  0.308 for mental health, and - 0.372 for total) (p < 0.05). In addition, the VAS score was significantly correlated with cervical lordosis (CL) (rs = 0.296), lumbar lordosis (rs = - 0.299), and sacral slope (rs = 0.362) (p < 0.05). Furthermore, at the 10-year follow-up, CL was significantly negatively correlated with T1 slope (rs = - 0.763) and thoracic kyphosis (TK) (- 0.554 for T1-12 and - 0.344 for T5-12) (p < 0.02).
    Conclusion: NSP was associated with deterioration in SRS-22 scores, indicating that NSP is a clinically significant long-term issue in PSF for thoracic AIS. Restoring or maintaining the TK and T1 slopes, which are controllable factors during PSF, may improve cervical lordosis and alleviate NSP at 10-year follow-up.
    Language English
    Publishing date 2024-04-04
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1115375-1
    ISSN 1432-0932 ; 0940-6719
    ISSN (online) 1432-0932
    ISSN 0940-6719
    DOI 10.1007/s00586-024-08233-6
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    Zs.A 3437: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: Axial Neck-Shoulder Pain After Posterior Correction and Fusion for Adolescent Idiopathic Scoliosis With Structural Thoracic Curve: Does Cranial Fusion Level Affect Neck Symptoms?

    Watanabe, Kei / Ohashi, Masayuki / Tashi, Hideki / Shibuya, Yohei / Makino, Tatsuo / Hasegawa, Kazuhiro / Hirano, Toru

    Clinical spine surgery

    2022  Volume 36, Issue 7, Page(s) E311–E316

    Abstract: Study design: A retrospective cohort study using prospectively collected data.: Objectives: To investigate the incidence and impact of fusion to the upper thoracic spine on neck-shoulder symptoms after posterior spinal fusion (PSF) for adolescent ... ...

    Abstract Study design: A retrospective cohort study using prospectively collected data.
    Objectives: To investigate the incidence and impact of fusion to the upper thoracic spine on neck-shoulder symptoms after posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS).
    Summary of background data: Axial neck-shoulder pain is established as a sequela of posterior cervical spine surgery and is mainly caused by the dissection of extensor muscles in the cervical and upper thoracic spine.
    Materials and methods: Sixty-three female patients with AIS who underwent PSF using segmental pedicle screw constructs for structural main thoracic curve with a minimum 2-year follow-up were included. Axial neck-shoulder pain was assessed using the visual analog scale and cervical spine function domain score of the Japanese Orthopedic Association Cervical Myelopathy Evaluation Questionnaire. The patients were divided into 2 groups, a higher group (underwent fusion up to T3 or above, n=27) and a lower group (underwent fusion up to T4 or below, n=36), and radiologic and clinical outcomes were compared.
    Results: The incidence of axial neck-shoulder pain (visual analog scale ≥30) preoperatively and at the 2-year follow-up was 29 and 40%, respectively. The pain and mental health domains of the Scoliosis Research Society-22 and cervical spine function domain of the Japanese Orthopedic Association Cervical Myelopathy Evaluation Questionnaire were correlated with the severity of axial neck pain. In the comparison of clinical outcomes between the 2 groups, the pain domain score of the Scoliosis Research Society-22 in the lower group was significantly better than that in the higher group at the 2-year follow-up ( P <0.05). Other parameters showed no significant differences preoperatively or at the 2-year follow-up.
    Conclusion: Female patients with AIS had a relatively high incidence of axial neck-shoulder pain after PSF, which affected their health-related quality of life. Both groups showed similar clinical outcomes, and the cranial fusion level did not affect axial neck-shoulder pain and cervical spine function.
    Level of evidence: Level 3.
    MeSH term(s) Humans ; Adolescent ; Female ; Scoliosis/surgery ; Retrospective Studies ; Quality of Life ; Shoulder Pain ; Thoracic Vertebrae/surgery ; Kyphosis ; Spinal Cord Diseases ; Spinal Fusion/adverse effects ; Treatment Outcome ; Follow-Up Studies
    Language English
    Publishing date 2022-08-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2849646-2
    ISSN 2380-0194 ; 2380-0186
    ISSN (online) 2380-0194
    ISSN 2380-0186
    DOI 10.1097/BSD.0000000000001370
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    Zs.A 2427: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
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  3. Article ; Online: Association of success of brace treatment and various aspects of in-brace correction in patients with adolescent idiopathic scoliosis.

    Sato, Masayuki / Ohashi, Masayuki / Tashi, Hideki / Makino, Tatsuo / Shibuya, Yohei / Hirano, Toru / Watanabe, Kei

    Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association

    2022  Volume 28, Issue 6, Page(s) 1221–1226

    Abstract: Background: Although skeletal maturity and brace wear time contribute to the success of brace treatment in adolescent idiopathic scoliosis (AIS), the extent of initial in-brace correction for ensuring successful outcomes remains unclear. We hypothesized ...

    Abstract Background: Although skeletal maturity and brace wear time contribute to the success of brace treatment in adolescent idiopathic scoliosis (AIS), the extent of initial in-brace correction for ensuring successful outcomes remains unclear. We hypothesized that the degree of initial in-brace correction correlates with brace success in patients with AIS.
    Method: The study included 135 AIS patients with a major Cobb angle of 20°-40° treated with a thoracic lumbosacral orthosis for at least one year and followed up for skeletal maturity. The subjects were divided into two groups: the skeletally immature group (group I, n = 72), who met the Bracing in Adolescent Idiopathic Scoliosis Trial study protocol at the start of brace treatment, and the skeletally mature group (group M, n = 63). Treatment success was defined as not needing surgical treatment and a major Cobb angle <40° at the end of brace treatment.
    Results: In both groups, the mean major Cobb angles before treatment, while wearing the brace, and at the end of brace treatment were 30.6°/31.7°, 22.9°/24.2°, and 38.8°/33.9° (p < 0.05), respectively, and the treatment success rate was 56.9% and 77.8%, respectively (p < 0.05). Univariate regression analysis revealed the following risk factors: Risser grade 0 in group I, major Cobb angles before treatment, initial in-brace major Cobb angle, and in-brace correction rate in both groups. Cutoff values of in-brace major Cobb angle for treatment success calculated by ROC curve in groups I and M were 24° and 29°, respectively.
    Conclusions: In-brace major scoliosis correction of <25° in patients with immature skeletal status and <30° in patients with mature skeletal structure should be aimed at to achieve significant brace treatment success.
    MeSH term(s) Humans ; Adolescent ; Scoliosis/diagnostic imaging ; Scoliosis/therapy ; Retrospective Studies ; Braces ; Kyphosis ; Orthotic Devices ; Treatment Outcome
    Language English
    Publishing date 2022-11-10
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 1314243-4
    ISSN 1436-2023 ; 0949-2658
    ISSN (online) 1436-2023
    ISSN 0949-2658
    DOI 10.1016/j.jos.2022.10.001
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    Zs.A 4484: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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  4. Article ; Online: Gait Analysis by the Severity of Gait Disturbance in Patients with Compressive Cervical Myelopathy.

    Makino, Tatsuo / Watanabe, Kei / Mizouchi, Tatsuki / Urakawa, Takaaki / Ohashi, Masayuki / Tashi, Hideki / Minato, Keitaro / Tanaka, Yuki / Kawashima, Hiroyuki

    Spine surgery and related research

    2023  Volume 7, Issue 6, Page(s) 488–495

    Abstract: Introduction: Gait disturbance due to compressive cervical myelopathy has been previously described. However, data on how gait disturbance varies with the degree of lower extremity motor impairment are limited. Therefore, we investigated the ... ...

    Abstract Introduction: Gait disturbance due to compressive cervical myelopathy has been previously described. However, data on how gait disturbance varies with the degree of lower extremity motor impairment are limited. Therefore, we investigated the characteristics of gait analysis based on severity and determined how gait disturbance progresses in compressive cervical myelopathy.
    Methods: We enrolled 44 patients (32 men and 12 women; mean age, 65.0 years) out of 108 consecutive patients with compressive cervical myelopathy who underwent spinal cord decompression surgery in our hospital. The exclusion criteria were inability to gait and complications affecting gait. Twenty-two patients with Japanese Orthopaedic Association scores 1 or 2 for lower extremity motor functions were assigned to the severe group, and 22 patients who scored 3 or 4 were assigned to the moderate group. Gait analysis was performed preoperatively using a long thin-type sensor sheet, and 25 healthy volunteers were assigned to the control group.
    Results: Stride length, swing phase, and gait speed decreased whereas step angle, stance phase, and double support duration increased as myelopathy progressed. Step width was significantly larger in the severe group than in the moderate and control groups. The cutoff values based on severe myelopathy with the inability to ascend or descend stairs without support were 60% for the stride length percentage of body height and 100 cm/s for gait speed.
    Conclusions: Decreases in stride length, swing phase, and gait speed and increases in step angle, stance phase, and double support duration are compensatory changes as cervical myelopathy progresses. Step width is a compensatory change that is not significantly altered in moderate myelopathy but increases when gait becomes affected, such that the patient cannot ascend or descend stairs without support.
    Language English
    Publishing date 2023-07-06
    Publishing country Japan
    Document type Journal Article
    ISSN 2432-261X
    ISSN (online) 2432-261X
    DOI 10.22603/ssrr.2023-0104
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  5. Article ; Online: Anatomical Pelvic Parameters Using the Anterior Pelvic Plane: Normative Values and Estimation of the Standing Sagittal Alignment in Healthy Volunteers.

    Ohashi, Masayuki / Hasegawa, Kazuhiro / Hatsushikano, Shun / Imai, Norio / Tashi, Hideki / Makino, Tatsuo / Minato, Keitaro / Sato, Masayuki / Watanabe, Kei

    Spine surgery and related research

    2023  Volume 8, Issue 1, Page(s) 97–105

    Abstract: Introduction: In this study, we aim to estimate the natural standing sagittal alignment in patients with adult spinal deformity (ASD), firstly by investigating the normative values of anatomical pelvic parameters based on the anterior pelvic plane (APP) ...

    Abstract Introduction: In this study, we aim to estimate the natural standing sagittal alignment in patients with adult spinal deformity (ASD), firstly by investigating the normative values of anatomical pelvic parameters based on the anterior pelvic plane (APP) in a healthy population, and to clarify the relationships between the anatomical and positional pelvic parameters in standing position.
    Methods: The images of biplanar slot-scanning full-body stereoradiography in 140 healthy Japanese volunteers (mean age, 39.5 years; 59.3% female) were examined. In addition to three-dimensional measurements including pelvic incidence (PI), sacral slope (SS), and pelvic tilt (PT), the APP angle (APPA; anterior tilting=positive) was measured as the angle between the APP and the vertical line using the two-dimensional lateral image. Anatomical SS and PT (aSS and aPT) were calculated as the angles of SS and PT in reference to APP.
    Results: The mean (range) values of APPA, aSS, and aPT were determined to be 0.7° (-16.8°/15.5°), 36.8° (18.3°/64.9°), and 13.2° (-0.6°/28.7°), respectively. Moreover, SS was found to be significantly correlated with PI and aSS, while PT was significantly correlated with PI, aSS, aPT, and body weight. Also, PT was significantly larger in females than in males. Multiple linear regression analysis deduced the following equations: SS=0.404×aSS+0.203×PI+12.463, PT=-0.391×aSS+0.774×PI+1.950×sex (male=0, female=1)-12.971, wherein aSS had the greatest effect for predicting SS among the included factors and PI had the greatest effect for predicting PT. In addition, no significant differences were noted between PT/PI and aPT/PI.
    Conclusions: As per the results of this study, significant correlations were noted among parameters and predicting models for positional parameters (SS and PT) using anatomical parameters (aSS and aPT) in a healthy population. This novel measurement concept based on the APP has been considered to be useful in estimating natural SS and PT in standing position using the anatomical pelvic parameters in patients with ASD.
    Language English
    Publishing date 2023-11-02
    Publishing country Japan
    Document type Journal Article
    ISSN 2432-261X
    ISSN (online) 2432-261X
    DOI 10.22603/ssrr.2023-0181
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  6. Article ; Online: Marriage and childbirth of patients who were surgically and non-surgically treated for adolescent idiopathic scoliosis: a survey at the age of 30 years or older.

    Ohashi, Masayuki / Watanabe, Kei / Hirano, Toru / Hasegawa, Kazuhiro / Katsumi, Keiichi / Tashi, Hideki / Shibuya, Yohei / Makino, Tatsuo / Kawashima, Hiroyuki

    Spine deformity

    2023  Volume 11, Issue 3, Page(s) 597–603

    Abstract: Purpose: We aimed to investigate the marital status and childbirth in adolescent idiopathic scoliosis (AIS) patients.: Methods: This study included women who were treated surgically or non-surgically for AIS with a scoliosis magnitude ≥ 30° before ... ...

    Abstract Purpose: We aimed to investigate the marital status and childbirth in adolescent idiopathic scoliosis (AIS) patients.
    Methods: This study included women who were treated surgically or non-surgically for AIS with a scoliosis magnitude ≥ 30° before surgery or at skeletal maturity and were followed up until age 30 years or older. Patients were divided into surgically treated (S-AIS, n = 55) and non-surgically treated AIS groups (N-AIS, n = 86). Data from the national fertility survey were used as control values.
    Results: There were no significant differences in age at the final follow-up between the S- (40.7 years) and N-AIS (42.1 years) groups. The unmarried rate among all women and the nulliparous rate among married women in the S-AIS group (29.1% and 18.4%, respectively) were similar to those in the N-AIS group (26.7% and 16.1%, respectively). The mean number of children per married woman also did not differ between the S- and N-AIS groups (1.5 vs 1.4). Compared to the control group, after adjusting for age, the common odds ratio in the AIS group was 1.56 (p = 0.031) for unmarried status and 1.88 (p = 0.026) for nulliparity among married women. Moreover, the mean number of children per married woman was significantly lower in the AIS group than in the control group (1.3 vs 1.7, p < 0.001).
    Conclusion: Surgically and non-surgically treated women with AIS had a similar status with regard to marriage and childbirth, while women with AIS were more likely to be unmarried and nulliparous and to have fewer children compared to the nationwide population.
    MeSH term(s) Child ; Humans ; Pregnancy ; Female ; Adolescent ; Adult ; Scoliosis/surgery ; Marriage ; Surveys and Questionnaires ; Spinal Fusion
    Language English
    Publishing date 2023-01-29
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2717704-X
    ISSN 2212-1358 ; 2212-134X ; 2212-1358
    ISSN (online) 2212-1358 ; 2212-134X
    ISSN 2212-1358
    DOI 10.1007/s43390-023-00648-3
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  7. Article ; Online: Characteristics of back pain in patients with adolescent idiopathic scoliosis: Considerations in candidates for corrective surgery.

    Kusabe, Yuta / Hirano, Toru / Kikuchi, Ren / Ohashi, Masayuki / Tashi, Hideki / Shibuya, Yohei / Makino, Tatsuo / Hasegawa, Kazuhiro / Tanabe, Naohito / Watanabe, Kei

    Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association

    2023  

    Abstract: Background: Previous studies have demonstrated that the point prevalence of back pain ranges from 12 % to 33 % and that the lifetime prevalence of back pain ranges from 28 % to 51 % in adolescents. However, few studies on back pain in patients with ... ...

    Abstract Background: Previous studies have demonstrated that the point prevalence of back pain ranges from 12 % to 33 % and that the lifetime prevalence of back pain ranges from 28 % to 51 % in adolescents. However, few studies on back pain in patients with Adolescent idiopathic scoliosis (AIS) have been conducted, and these studies had significant limitations, including a lack of comparative controls and detailed information about scoliotic deformity or pain location. This study aimed to determine whether adolescents with AIS experience back pain in specific regions.
    Methods: This retrospective case-control study included 189 female adolescents with AIS who underwent corrective fusion from 2008 to 2020. Questionnaires on back pain and health-related quality of life (HRQOL) using the Scoliosis Research Society Outcomes Instrument-22 (SRS-22) were conducted preoperatively. The control group included 2909 general female adolescents.
    Results: The mean Cobb angles in the main thoracic and thoracolumbar/lumbar curves were 51.4 ± 15.3° and 40.4 ± 12.9°. Back pain characteristics included higher point prevalence (25.9 %) and lifetime prevalence (64.6 %) compared to healthy controls. Adolescents with back pain showed lower scores in the pain and mental health domains of the SRS-22. Adolescents with major thoracic AIS showed more back pain in the upper and middle right back compared to adolescents with major thoracolumbar/lumbar AIS.
    Conclusion: The point and lifetime prevalence of back pain were definitely higher in patients with AIS, which affected their HRQOL. There was a relationship between pain around the right scapula and the right major thoracic curve with a rib hump deformity.
    Language English
    Publishing date 2023-12-07
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 1314243-4
    ISSN 1436-2023 ; 0949-2658
    ISSN (online) 1436-2023
    ISSN 0949-2658
    DOI 10.1016/j.jos.2023.11.014
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    Zs.A 4484: Show issues Location:
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  8. Article ; Online: Usefulness and limitations of intraoperative pathological diagnosis using frozen sections for spinal cord tumors.

    Tanaka, Yuki / Hirano, Toru / Ohashi, Masayuki / Tashi, Hideki / Makino, Tatsuo / Minato, Keitaro / Kawashima, Hiroyuki / Kakita, Akiyoshi / Hasegawa, Kazuhiro / Watanabe, Kei

    Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association

    2023  

    Abstract: Background: Intraoperative pathological diagnosis has a major influence on the intra- and postoperative management of spinal cord tumors. Thus, the aim of this study was to assess the reliability of intraoperative pathological diagnosis for spinal cord ... ...

    Abstract Background: Intraoperative pathological diagnosis has a major influence on the intra- and postoperative management of spinal cord tumors. Thus, the aim of this study was to assess the reliability of intraoperative pathological diagnosis for spinal cord lesions by comparing it with the final pathological diagnosis and to determine its usefulness and limitations.
    Method: Three-hundred and three consecutive patients (mean age, 53.9 years) with neoplastic spinal cord lesions who underwent initial surgery between 2000 and 2021 were included. The anatomical locations of the spinal cord tumors and the implementation rate of intraoperative pathological diagnosis in each tumor type were evaluated. As the primary outcome, we determined the concordance rates between the intraoperative pathological diagnosis and the final diagnosis. When the intraoperative pathological diagnosis and final diagnosis were the same, the diagnosis was defined as a "match." Otherwise, the diagnosis was defined as a "mismatch."
    Results: The overall implementation rate of intraoperative pathological diagnosis was 53%, with implementation rates of 71%, 45%, 47%, and 50% for intramedullary, intradural extramedullary, extradural, and dumbbell tumors, respectively. The overall concordance rate was 87.6%, with concordance rates of 80%, 95%, 75%, and 90% for intramedullary, intradural extramedullary, extradural, and dumbbell tumors, respectively (p < 0.05). The diagnoses of ependymomas, low-grade astrocytomas, and high-grade astrocytomas was occasionally difficult among intramedullary tumors. Among intradural extramedullary tumors, differentiation between grade 1 meningioma and high-grade meningioma was difficult using intraoperative pathological diagnosis.
    Conclusions: Surgeons must recognize the lower accuracy of intraoperative pathological diagnosis for intramedullary and extradural lesions and make a final decision by considering the intraoperative gross findings, preoperative clinical course, and imaging.
    Language English
    Publishing date 2023-08-25
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 1314243-4
    ISSN 1436-2023 ; 0949-2658
    ISSN (online) 1436-2023
    ISSN 0949-2658
    DOI 10.1016/j.jos.2023.08.011
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  9. Article ; Online: Delayed paraparesis after posterior spinal fusion for congenital scoliosis: a case report.

    Ohtsubo, Shuhei / Ohashi, Masayuki / Hirano, Toru / Tashi, Hideki / Makino, Tatsuo / Minato, Keitaro / Mitsuma, Yusuke / Deguchi, Hiroyuki / Hoshino, Rintaro / Ohashi, Nobuko / Furutani, Kenta / Kawashima, Hiroyuki / Watanabe, Kei

    Spinal cord series and cases

    2024  Volume 10, Issue 1, Page(s) 24

    Abstract: Introduction: Although multimodal intraoperative neuromonitoring (IONM), which has high sensitivity and specificity, is typically performed during spinal deformity surgery, neurological status may deteriorate with delay after surgical maneuvers. Here, ... ...

    Abstract Introduction: Although multimodal intraoperative neuromonitoring (IONM), which has high sensitivity and specificity, is typically performed during spinal deformity surgery, neurological status may deteriorate with delay after surgical maneuvers. Here, we report a rare case of delayed postoperative neurological deficit (DPND) that was not detected by IONM during posterior spinal fusion (PSF) for congenital scoliosis.
    Case presentation: A 14-year-old male presented with congenital scoliosis associated with T3 and T10 hemivertebrae. Preoperative Cobb angle of proximal thoracic (PT) and main thoracic (MT) curves were 50° and 41°, respectively. PSF (T1-L1) without hemivertebrectomy was performed, and the curves were corrected to 31° and 21° in the PT and MT curves, respectively, without any abnormal findings in IONM, blood pressure, or hemoglobin level. However, postoperative neurological examination revealed complete loss of motor function. A revision surgery, release of the curve correction by removing the rods, was immediately performed and muscle strength completely recovered on the first postoperative day. Five days postoperatively, PSF was achieved with less curve correction (36° in the PT curve and 26° in the MT curve), without postoperative neurological deficits.
    Discussion: Possible mechanisms of DPND in our patient are spinal cord ischemia due to spinal cord traction caused by scoliosis correction and spinal cord kinking by the pedicle at the concave side. Understanding the possible mechanisms of intra- and postoperative neural injury is essential for appropriate intervention in each situation. Additionally, IONM should be continued to at least skin closure to detect DPND observed in our patient.
    MeSH term(s) Male ; Humans ; Adolescent ; Scoliosis/congenital ; Scoliosis/surgery ; Thoracic Vertebrae/surgery ; Spinal Fusion ; Treatment Outcome ; Retrospective Studies
    Language English
    Publishing date 2024-04-17
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 2058-6124
    ISSN (online) 2058-6124
    DOI 10.1038/s41394-024-00639-0
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  10. Article ; Online: Evaluating flexibility and predicting curve correction using fulcrum-bending radiographs in Lenke type 2 adolescent idiopathic scoliosis.

    Watanabe, Kei / Ohashi, Masayuki / Sekimoto, Hiroyuki / Tashi, Hideki / Shibuya, Yohei / Makino, Tatsuo / Hasegawa, Kazuhiro / Hirano, Toru

    Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association

    2022  Volume 28, Issue 3, Page(s) 529–535

    Abstract: Background: Fulcrum-bending (FB) correction is considered to provide the best estimation of main thoracic (MT) curve flexibility and postoperative correction in surgical treatment for adolescent idiopathic scoliosis (AIS). However, few studies evaluated ...

    Abstract Background: Fulcrum-bending (FB) correction is considered to provide the best estimation of main thoracic (MT) curve flexibility and postoperative correction in surgical treatment for adolescent idiopathic scoliosis (AIS). However, few studies evaluated the usefulness of FB radiographs for proximal thoracic (PT) curve. We aimed to perform flexibility assessments using both active side-bending (SB) and FB radiographs and evaluate surgical outcomes after posterior spinal fusion (PSF) for Lenke type 2 AIS.
    Methods: This study included 38 consecutive patients with Lenke type 2 AIS who underwent PSF using a pedicle screw construct with a minimum 2-year follow-up. Radiographic parameters, including correction rate, SB and FB flexibility, and FB correction index (FBCI: [correction rate/FB flexibility] × 100), were evaluated preoperatively, immediately after surgery, and at the 2-year follow-up. The clinical outcomes were preoperatively evaluated using the Scoliosis Research Outcomes Instrument-22 and at the follow-up.
    Results: All scoliosis curves significantly improved and shoulder balance shifted toward left shoulder elevation (all comparisons, p < 0.0001). There were significant differences between the SB and FB corrections in the PT and MT curves (p < 0.0001). The magnitudes of the discrepancies between the SB and FB corrections in the PT and MT curves were 11.2° ± 5.2° and 11.6° ± 7.2°, respectively. FB correction did not differ from postoperative Cobb angles correction immediately after surgery or at the 2-year follow-up; the mean FBCIs in the PT and MT curves were 98.8% and 105.5%, respectively. The self-image domain SRS-22 scores had significantly increased at the 2-year follow-up (p < 0.0001).
    Conclusions: There were significant differences between the SB and FB corrections, and FB correction tended to approximate the postoperative curve correction (FBCI = 100%) for PT and MT curves in patients with Lenke type 2 AIS. FB flexibility is more reliable than SB flexibility in evaluating actual curve flexibility even for the PT curve.
    MeSH term(s) Humans ; Adolescent ; Scoliosis/diagnostic imaging ; Scoliosis/surgery ; Thoracic Vertebrae/diagnostic imaging ; Thoracic Vertebrae/surgery ; Radiography ; Kyphosis ; Pedicle Screws ; Spinal Fusion/methods ; Retrospective Studies ; Treatment Outcome
    Language English
    Publishing date 2022-03-04
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 1314243-4
    ISSN 1436-2023 ; 0949-2658
    ISSN (online) 1436-2023
    ISSN 0949-2658
    DOI 10.1016/j.jos.2022.01.015
    Database MEDical Literature Analysis and Retrieval System OnLINE

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