Evaluation of the Radiographic Risk Factors of Postoperative Shoulder Imbalance in Adult Scoliosis
ObjectiveThis study aimed to evaluate the radiographic risk factors of postoperative shoulder imbalance (PSI) after adult scoliosis (AS) correction surgery.MethodsSeventy-nine patients with AS undergoing correction surgery at a single institution were reviewed. The mean follow-up was 28 months. Pati...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-06-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.885949/full |
| _version_ | 1818238715243266048 |
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| author | Wencan Ke Bingjin Wang Wenbin Hua Kun Wang Shuai Li Cao Yang |
| author_facet | Wencan Ke Bingjin Wang Wenbin Hua Kun Wang Shuai Li Cao Yang |
| author_sort | Wencan Ke |
| collection | DOAJ |
| description | ObjectiveThis study aimed to evaluate the radiographic risk factors of postoperative shoulder imbalance (PSI) after adult scoliosis (AS) correction surgery.MethodsSeventy-nine patients with AS undergoing correction surgery at a single institution were reviewed. The mean follow-up was 28 months. Patients were divided into two groups based on their radiographic shoulder height (RSH): (1) the balanced group (RSH <10 mm) and (2) the unbalanced group (RSH ≥10 mm). The preoperative and postoperative Cobb angles of the proximal thoracic (PT), main thoracic (MT), thoracolumbar/lumbar (TL/L) and upper instrumented vertebra (UIV) were measured.ResultsNo significant difference was found between the balanced and unbalanced groups when the UIV was T1–2, T3–4, or below T4. Univariate analysis indicated that the unbalanced group had significantly higher postoperative RSH, lower percentage PT correction, and greater percentage MT correction. The classification and regression tree analysis revealed that when the correction percentage of PT curve was more than 55.3%, 84.4% of patients acquired shoulder balance. However, when the correction percentage of PT curve was less than 55.3%, and the correction percentage of MT curve was more than 56%, 65.7% of the patients developed PSI.ConclusionsIn AS correction surgery, a lower percentage correction of the PT curve and greater percentage correction of the MT curve were independent radiographic risk factors of PSI, regardless of the UIV level. Sufficient PT correction is required to achieve postoperative shoulder balance in AS correction surgery when the MT curve is overcorrected. |
| first_indexed | 2024-12-12T12:46:03Z |
| format | Article |
| id | doaj.art-2120992413474e8e8170102ea0182101 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-12-12T12:46:03Z |
| publishDate | 2022-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-2120992413474e8e8170102ea01821012022-12-22T00:24:07ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2022-06-01910.3389/fsurg.2022.885949885949Evaluation of the Radiographic Risk Factors of Postoperative Shoulder Imbalance in Adult ScoliosisWencan KeBingjin WangWenbin HuaKun WangShuai LiCao YangObjectiveThis study aimed to evaluate the radiographic risk factors of postoperative shoulder imbalance (PSI) after adult scoliosis (AS) correction surgery.MethodsSeventy-nine patients with AS undergoing correction surgery at a single institution were reviewed. The mean follow-up was 28 months. Patients were divided into two groups based on their radiographic shoulder height (RSH): (1) the balanced group (RSH <10 mm) and (2) the unbalanced group (RSH ≥10 mm). The preoperative and postoperative Cobb angles of the proximal thoracic (PT), main thoracic (MT), thoracolumbar/lumbar (TL/L) and upper instrumented vertebra (UIV) were measured.ResultsNo significant difference was found between the balanced and unbalanced groups when the UIV was T1–2, T3–4, or below T4. Univariate analysis indicated that the unbalanced group had significantly higher postoperative RSH, lower percentage PT correction, and greater percentage MT correction. The classification and regression tree analysis revealed that when the correction percentage of PT curve was more than 55.3%, 84.4% of patients acquired shoulder balance. However, when the correction percentage of PT curve was less than 55.3%, and the correction percentage of MT curve was more than 56%, 65.7% of the patients developed PSI.ConclusionsIn AS correction surgery, a lower percentage correction of the PT curve and greater percentage correction of the MT curve were independent radiographic risk factors of PSI, regardless of the UIV level. Sufficient PT correction is required to achieve postoperative shoulder balance in AS correction surgery when the MT curve is overcorrected.https://www.frontiersin.org/articles/10.3389/fsurg.2022.885949/fulladult scoliosiscorrection surgerypostoperative shoulder imbalanceupper instrumented vertebra (UIV)radiographic shoulder height |
| spellingShingle | Wencan Ke Bingjin Wang Wenbin Hua Kun Wang Shuai Li Cao Yang Evaluation of the Radiographic Risk Factors of Postoperative Shoulder Imbalance in Adult Scoliosis Frontiers in Surgery adult scoliosis correction surgery postoperative shoulder imbalance upper instrumented vertebra (UIV) radiographic shoulder height |
| title | Evaluation of the Radiographic Risk Factors of Postoperative Shoulder Imbalance in Adult Scoliosis |
| title_full | Evaluation of the Radiographic Risk Factors of Postoperative Shoulder Imbalance in Adult Scoliosis |
| title_fullStr | Evaluation of the Radiographic Risk Factors of Postoperative Shoulder Imbalance in Adult Scoliosis |
| title_full_unstemmed | Evaluation of the Radiographic Risk Factors of Postoperative Shoulder Imbalance in Adult Scoliosis |
| title_short | Evaluation of the Radiographic Risk Factors of Postoperative Shoulder Imbalance in Adult Scoliosis |
| title_sort | evaluation of the radiographic risk factors of postoperative shoulder imbalance in adult scoliosis |
| topic | adult scoliosis correction surgery postoperative shoulder imbalance upper instrumented vertebra (UIV) radiographic shoulder height |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.885949/full |
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