Clinical Outcomes and Complications of Corrective Fusion Surgery Down to L4, L5, and the Pelvis for Adult Scoliosis in Patients Younger than 50 Years
Introduction: Corrective fusion for adult scoliosis often requires fusion from the thoracic spine to the lower lumbar spine or pelvis. However, it is often difficult to determine the lowest instrumented vertebrae (LIV), especially in younger patients. The purpose of this study was to summarize the c...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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The Japanese Society for Spine Surgery and Related Research
2022-09-01
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| Series: | Spine Surgery and Related Research |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/ssrr/6/5/6_2021-0220/_pdf/-char/en |
| _version_ | 1811339374424489984 |
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| author | Hideyuki Arima Tomohiko Hasegawa Yu Yamato Go Yoshida Tomohiro Banno Shin Oe Yuki Mihara Koichiro Ide Yuh Watanabe Keiichi Nakai Kenta Kurosu Yukihiro Matsuyama |
| author_facet | Hideyuki Arima Tomohiko Hasegawa Yu Yamato Go Yoshida Tomohiro Banno Shin Oe Yuki Mihara Koichiro Ide Yuh Watanabe Keiichi Nakai Kenta Kurosu Yukihiro Matsuyama |
| author_sort | Hideyuki Arima |
| collection | DOAJ |
| description | Introduction: Corrective fusion for adult scoliosis often requires fusion from the thoracic spine to the lower lumbar spine or pelvis. However, it is often difficult to determine the lowest instrumented vertebrae (LIV), especially in younger patients. The purpose of this study was to summarize the clinical outcomes and revision surgery rates after corrective fusion for adult scoliosis at different LIV levels in patients under 50 years of age.
Methods: We retrospectively analyzed 25 patients with adult scoliosis (mean age, 38 years; mean follow-up, 65 months) who underwent corrective fusion from the thoracic spine to L4, L5, or pelvis between 2010 and 2018. Preoperative and at least 2 years' postoperative radiographic parameters, patient-reported outcomes (Scoliosis Research Society-22r [SRS-22r]), mechanical complications, and revision surgery were investigated, and comparisons were made between two groups: the L4 and L5 (L) group (n=14) and the pelvic group (n=11).
Results: Both groups showed a significant improvement in the SRS-22r domains of Self-image and Subtotal postoperatively compared with the baseline (P<0.05). The incidence of rod fracture was significantly higher in the pelvic group (5 patients, 45%) than in the L group (0 patients, 0%) (P=0.001). In addition, revision surgery was performed five times in 4 patients (36%) in the pelvic group compared with 0 in the L group (P=0.068).
Conclusions: In the L group, clinical outcomes improved in the medium term, with no patients requiring revision surgery. In the pelvic group, the rod fracture rate was higher, but the clinical outcomes improved. |
| first_indexed | 2024-04-13T18:25:55Z |
| format | Article |
| id | doaj.art-78762309d0ea46bbbb4386048b5aa980 |
| institution | Directory Open Access Journal |
| issn | 2432-261X |
| language | English |
| last_indexed | 2024-04-13T18:25:55Z |
| publishDate | 2022-09-01 |
| publisher | The Japanese Society for Spine Surgery and Related Research |
| record_format | Article |
| series | Spine Surgery and Related Research |
| spelling | doaj.art-78762309d0ea46bbbb4386048b5aa9802022-12-22T02:35:15ZengThe Japanese Society for Spine Surgery and Related ResearchSpine Surgery and Related Research2432-261X2022-09-016551852510.22603/ssrr.2021-02202021-0220Clinical Outcomes and Complications of Corrective Fusion Surgery Down to L4, L5, and the Pelvis for Adult Scoliosis in Patients Younger than 50 YearsHideyuki Arima0Tomohiko Hasegawa1Yu Yamato2Go Yoshida3Tomohiro Banno4Shin Oe5Yuki Mihara6Koichiro Ide7Yuh Watanabe8Keiichi Nakai9Kenta Kurosu10Yukihiro Matsuyama11Department of Orthopaedic Surgery, Hamamatsu University School of MedicineDepartment of Orthopaedic Surgery, Hamamatsu University School of MedicineDepartment of Orthopaedic Surgery, Hamamatsu University School of MedicineDepartment of Orthopaedic Surgery, Hamamatsu University School of MedicineDepartment of Orthopaedic Surgery, Hamamatsu University School of MedicineDepartment of Orthopaedic Surgery, Hamamatsu University School of MedicineDepartment of Orthopaedic Surgery, Hamamatsu University School of MedicineDepartment of Orthopaedic Surgery, Hamamatsu University School of MedicineDepartment of Orthopaedic Surgery, Hamamatsu University School of MedicineDepartment of Orthopaedic Surgery, Hamamatsu University School of MedicineDepartment of Orthopaedic Surgery, Hamamatsu University School of MedicineDepartment of Orthopaedic Surgery, Hamamatsu University School of MedicineIntroduction: Corrective fusion for adult scoliosis often requires fusion from the thoracic spine to the lower lumbar spine or pelvis. However, it is often difficult to determine the lowest instrumented vertebrae (LIV), especially in younger patients. The purpose of this study was to summarize the clinical outcomes and revision surgery rates after corrective fusion for adult scoliosis at different LIV levels in patients under 50 years of age. Methods: We retrospectively analyzed 25 patients with adult scoliosis (mean age, 38 years; mean follow-up, 65 months) who underwent corrective fusion from the thoracic spine to L4, L5, or pelvis between 2010 and 2018. Preoperative and at least 2 years' postoperative radiographic parameters, patient-reported outcomes (Scoliosis Research Society-22r [SRS-22r]), mechanical complications, and revision surgery were investigated, and comparisons were made between two groups: the L4 and L5 (L) group (n=14) and the pelvic group (n=11). Results: Both groups showed a significant improvement in the SRS-22r domains of Self-image and Subtotal postoperatively compared with the baseline (P<0.05). The incidence of rod fracture was significantly higher in the pelvic group (5 patients, 45%) than in the L group (0 patients, 0%) (P=0.001). In addition, revision surgery was performed five times in 4 patients (36%) in the pelvic group compared with 0 in the L group (P=0.068). Conclusions: In the L group, clinical outcomes improved in the medium term, with no patients requiring revision surgery. In the pelvic group, the rod fracture rate was higher, but the clinical outcomes improved.https://www.jstage.jst.go.jp/article/ssrr/6/5/6_2021-0220/_pdf/-char/enadult scoliosisspino-pelvic parameterscorrective fusion surgerylowest instrumented vertebraepatient-reported outcome |
| spellingShingle | Hideyuki Arima Tomohiko Hasegawa Yu Yamato Go Yoshida Tomohiro Banno Shin Oe Yuki Mihara Koichiro Ide Yuh Watanabe Keiichi Nakai Kenta Kurosu Yukihiro Matsuyama Clinical Outcomes and Complications of Corrective Fusion Surgery Down to L4, L5, and the Pelvis for Adult Scoliosis in Patients Younger than 50 Years Spine Surgery and Related Research adult scoliosis spino-pelvic parameters corrective fusion surgery lowest instrumented vertebrae patient-reported outcome |
| title | Clinical Outcomes and Complications of Corrective Fusion Surgery Down to L4, L5, and the Pelvis for Adult Scoliosis in Patients Younger than 50 Years |
| title_full | Clinical Outcomes and Complications of Corrective Fusion Surgery Down to L4, L5, and the Pelvis for Adult Scoliosis in Patients Younger than 50 Years |
| title_fullStr | Clinical Outcomes and Complications of Corrective Fusion Surgery Down to L4, L5, and the Pelvis for Adult Scoliosis in Patients Younger than 50 Years |
| title_full_unstemmed | Clinical Outcomes and Complications of Corrective Fusion Surgery Down to L4, L5, and the Pelvis for Adult Scoliosis in Patients Younger than 50 Years |
| title_short | Clinical Outcomes and Complications of Corrective Fusion Surgery Down to L4, L5, and the Pelvis for Adult Scoliosis in Patients Younger than 50 Years |
| title_sort | clinical outcomes and complications of corrective fusion surgery down to l4 l5 and the pelvis for adult scoliosis in patients younger than 50 years |
| topic | adult scoliosis spino-pelvic parameters corrective fusion surgery lowest instrumented vertebrae patient-reported outcome |
| url | https://www.jstage.jst.go.jp/article/ssrr/6/5/6_2021-0220/_pdf/-char/en |
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