What Is the Role of Traction Test Radiographs in the Preoperative Planning of Adolescent Idiopathic Scoliosis?
Lower instrumented vertebra (LIV) selection is critical to avoid complications like adding-on. This study aims to determine the usefulness of the traction test (TR) in selecting the LIV during surgery for adolescent idiopathic scoliosis (AIS). We analyzed 42 AIS patients with Lenke 1 curves who had...
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MDPI AG
2023-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/22/6986 |
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| author | Giovanni Andrea La Maida Enrico Gallazzi Federica Ramella Marcello Ferraro Andrea Della Valle Davide Cecconi Bernardo Misaggi |
| author_facet | Giovanni Andrea La Maida Enrico Gallazzi Federica Ramella Marcello Ferraro Andrea Della Valle Davide Cecconi Bernardo Misaggi |
| author_sort | Giovanni Andrea La Maida |
| collection | DOAJ |
| description | Lower instrumented vertebra (LIV) selection is critical to avoid complications like adding-on. This study aims to determine the usefulness of the traction test (TR) in selecting the LIV during surgery for adolescent idiopathic scoliosis (AIS). We analyzed 42 AIS patients with Lenke 1 curves who had preoperative, postoperative, and at least 12-month follow-up X-rays, as well as preoperative side bending (SB) and TR radiograms. Neutral vertebra (NV), stable vertebra (SV), lower instrumented vertebra (LIV), and Cobb angles were identified and compared on all radiographic images. In 23 cases, the TR resulted in SV proximalization compared to the preoperative X-rays, while in 8 cases, SV-TR was more distal. This distalization occurred in 50% of Lenke 1C curves, where a greater correction of the distal curve was found. NV-TR was proximal to NV-preop in 9 cases, while NV-SB was proximal in 22 cases. LIV was proximal to SV-TR in 8 cases, while it was proximal to SV-preop in 22. One patient with LIV proximal to SV-TR developed adding-on. In conclusion, the TR is crucial in AIS preoperative planning as it provides information distinct from that of standard X-rays and SB: (1) it better assesses gravitational stability than rotational stability; and (2) choosing LIV equal to or proximal to SV-TR may prevent adding-on, except in ‘flexible’ Lenke 1C curves where LIV should be equal or distal to SV-preop. |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T16:43:42Z |
| publishDate | 2023-11-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-1f03b2180f4c457bbb4f5f4543104a6e2023-11-24T14:49:03ZengMDPI AGJournal of Clinical Medicine2077-03832023-11-011222698610.3390/jcm12226986What Is the Role of Traction Test Radiographs in the Preoperative Planning of Adolescent Idiopathic Scoliosis?Giovanni Andrea La Maida0Enrico Gallazzi1Federica Ramella2Marcello Ferraro3Andrea Della Valle4Davide Cecconi5Bernardo Misaggi6U.O.C. Ortopedia e Traumatologia per le Patologie della Colonna Vertebrale, ASST G. Pini—CTO, 20122 Milano, ItalyU.O.C. Ortopedia e Traumatologia per le Patologie della Colonna Vertebrale, ASST G. Pini—CTO, 20122 Milano, ItalyDipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20122 Milano, ItalyU.O.C. Ortopedia e Traumatologia per le Patologie della Colonna Vertebrale, ASST G. Pini—CTO, 20122 Milano, ItalyU.O.C. Ortopedia e Traumatologia per le Patologie della Colonna Vertebrale, ASST G. Pini—CTO, 20122 Milano, ItalyU.O.C. Ortopedia e Traumatologia per le Patologie della Colonna Vertebrale, ASST G. Pini—CTO, 20122 Milano, ItalyU.O.C. Ortopedia e Traumatologia per le Patologie della Colonna Vertebrale, ASST G. Pini—CTO, 20122 Milano, ItalyLower instrumented vertebra (LIV) selection is critical to avoid complications like adding-on. This study aims to determine the usefulness of the traction test (TR) in selecting the LIV during surgery for adolescent idiopathic scoliosis (AIS). We analyzed 42 AIS patients with Lenke 1 curves who had preoperative, postoperative, and at least 12-month follow-up X-rays, as well as preoperative side bending (SB) and TR radiograms. Neutral vertebra (NV), stable vertebra (SV), lower instrumented vertebra (LIV), and Cobb angles were identified and compared on all radiographic images. In 23 cases, the TR resulted in SV proximalization compared to the preoperative X-rays, while in 8 cases, SV-TR was more distal. This distalization occurred in 50% of Lenke 1C curves, where a greater correction of the distal curve was found. NV-TR was proximal to NV-preop in 9 cases, while NV-SB was proximal in 22 cases. LIV was proximal to SV-TR in 8 cases, while it was proximal to SV-preop in 22. One patient with LIV proximal to SV-TR developed adding-on. In conclusion, the TR is crucial in AIS preoperative planning as it provides information distinct from that of standard X-rays and SB: (1) it better assesses gravitational stability than rotational stability; and (2) choosing LIV equal to or proximal to SV-TR may prevent adding-on, except in ‘flexible’ Lenke 1C curves where LIV should be equal or distal to SV-preop.https://www.mdpi.com/2077-0383/12/22/6986AISLIVtraction testside bendingLenke 1 AIS |
| spellingShingle | Giovanni Andrea La Maida Enrico Gallazzi Federica Ramella Marcello Ferraro Andrea Della Valle Davide Cecconi Bernardo Misaggi What Is the Role of Traction Test Radiographs in the Preoperative Planning of Adolescent Idiopathic Scoliosis? Journal of Clinical Medicine AIS LIV traction test side bending Lenke 1 AIS |
| title | What Is the Role of Traction Test Radiographs in the Preoperative Planning of Adolescent Idiopathic Scoliosis? |
| title_full | What Is the Role of Traction Test Radiographs in the Preoperative Planning of Adolescent Idiopathic Scoliosis? |
| title_fullStr | What Is the Role of Traction Test Radiographs in the Preoperative Planning of Adolescent Idiopathic Scoliosis? |
| title_full_unstemmed | What Is the Role of Traction Test Radiographs in the Preoperative Planning of Adolescent Idiopathic Scoliosis? |
| title_short | What Is the Role of Traction Test Radiographs in the Preoperative Planning of Adolescent Idiopathic Scoliosis? |
| title_sort | what is the role of traction test radiographs in the preoperative planning of adolescent idiopathic scoliosis |
| topic | AIS LIV traction test side bending Lenke 1 AIS |
| url | https://www.mdpi.com/2077-0383/12/22/6986 |
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