Incidence and predictive factors of shoulder imbalance after selective anterior spinal fusion surgery in Lenke type 5C adolescent idiopathic scoliosis
ABSTRACT: Background: No study has assessed the incidence or predictors of postoperative shoulder imbalance (PSI) in patients with Lenke type 5C adolescent idiopathic scoliosis (AIS) who underwent selective anterior spinal fusion (ASF). This study evaluated the incidence and predictors of shoulder...
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| Format: | Article |
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Elsevier
2023-06-01
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| Series: | North American Spine Society Journal |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666548423000057 |
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| author | Toshiki Okubo, MD, PhD Tsunehiko Konomi, MD, PhD Yoshihide Yanai, MD Yoshiomi Kobayashi, MD, PhD Mitsuru Furukawa, MD, PhD Kanehiro Fujiyoshi, MD, PhD Takashi Asazuma, MD, PhD Yoshiyuki Yato, MD, PhD |
| author_facet | Toshiki Okubo, MD, PhD Tsunehiko Konomi, MD, PhD Yoshihide Yanai, MD Yoshiomi Kobayashi, MD, PhD Mitsuru Furukawa, MD, PhD Kanehiro Fujiyoshi, MD, PhD Takashi Asazuma, MD, PhD Yoshiyuki Yato, MD, PhD |
| author_sort | Toshiki Okubo, MD, PhD |
| collection | DOAJ |
| description | ABSTRACT: Background: No study has assessed the incidence or predictors of postoperative shoulder imbalance (PSI) in patients with Lenke type 5C adolescent idiopathic scoliosis (AIS) who underwent selective anterior spinal fusion (ASF). This study evaluated the incidence and predictors of shoulder imbalance after selective ASF for Lenke type 5C AIS. Methods: In total, 62 patients with Lenke type 5C AIS (4 men and 58 women, mean age at surgery of 15.5 ± 1.5 years) were included and divided into the following two groups according to the radiographic shoulder height (RSH) at the final follow-up: PSI and non-PSI groups. All patients in this study underwent a whole-spine radiological evaluation. Various spinal coronal and sagittal profiles on radiographs were compared between the 2 groups. The clinical outcomes were assessed using the Scoliosis Research Society (SRS)-22 questionnaires. Results: The mean final follow-up duration was 8.6 ± 2.7 years. PSI was observed in 10 patients (16.1%) immediately after surgery; however, in the long-term follow-up period, PSI improved in 3 patients spontaneously, whereas the remaining 7 patients had residual PSI. The preoperative RSH and correction rates of the major curve immediately after surgery or at the final follow-up were significantly larger in the PSI group than in the non-PSI group (p=.001, p=.023, and p=.019, respectively). Receiver operating characteristic curve analysis indicated that the cutoff values for preoperative RSH and the correction rates immediately after surgery and at the final follow-up were 11.79 mm (p=.002; area under the curve [AUC], 0.948), 71.0% (p=.026; AUC, 0.822), and 65.4% (p=.021; AUC, 0.835), respectively. No statistically significant difference was observed in the preoperative and final follow-up SRS-22 scores in any domain between the PSI and non-PSI groups. Conclusions: Paying attention to the preoperative RSH and avoiding excessive correction of the major curve can prevent the occurrence of shoulder imbalance after selective ASF for Lenke type 5C AIS. |
| first_indexed | 2024-03-13T03:31:39Z |
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| issn | 2666-5484 |
| language | English |
| last_indexed | 2024-03-13T03:31:39Z |
| publishDate | 2023-06-01 |
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| spelling | doaj.art-abd93a2f19ef422981044a7768fb903e2023-06-24T05:19:16ZengElsevierNorth American Spine Society Journal2666-54842023-06-0114100203Incidence and predictive factors of shoulder imbalance after selective anterior spinal fusion surgery in Lenke type 5C adolescent idiopathic scoliosisToshiki Okubo, MD, PhD0Tsunehiko Konomi, MD, PhD1Yoshihide Yanai, MD2Yoshiomi Kobayashi, MD, PhD3Mitsuru Furukawa, MD, PhD4Kanehiro Fujiyoshi, MD, PhD5Takashi Asazuma, MD, PhD6Yoshiyuki Yato, MD, PhD7Corresponding author. Department of Orthopaedic Surgery, National Hospital Organization, Murayama Medical Center, 2-37-1 Gakuen, Musahimurayama, Tokyo, Japan. Tel.: +81-42-561-1221; fax: +81-42-561-2547.; Department of Orthopaedic Surgery, National Hospital Organization, Murayama Medical Center, 2-37-1 Gakuen, Musahimurayama, Tokyo, JapanDepartment of Orthopaedic Surgery, National Hospital Organization, Murayama Medical Center, 2-37-1 Gakuen, Musahimurayama, Tokyo, JapanDepartment of Orthopaedic Surgery, National Hospital Organization, Murayama Medical Center, 2-37-1 Gakuen, Musahimurayama, Tokyo, JapanDepartment of Orthopaedic Surgery, National Hospital Organization, Murayama Medical Center, 2-37-1 Gakuen, Musahimurayama, Tokyo, JapanDepartment of Orthopaedic Surgery, National Hospital Organization, Murayama Medical Center, 2-37-1 Gakuen, Musahimurayama, Tokyo, JapanDepartment of Orthopaedic Surgery, National Hospital Organization, Murayama Medical Center, 2-37-1 Gakuen, Musahimurayama, Tokyo, JapanDepartment of Orthopaedic Surgery, National Hospital Organization, Murayama Medical Center, 2-37-1 Gakuen, Musahimurayama, Tokyo, JapanDepartment of Orthopaedic Surgery, National Hospital Organization, Murayama Medical Center, 2-37-1 Gakuen, Musahimurayama, Tokyo, JapanABSTRACT: Background: No study has assessed the incidence or predictors of postoperative shoulder imbalance (PSI) in patients with Lenke type 5C adolescent idiopathic scoliosis (AIS) who underwent selective anterior spinal fusion (ASF). This study evaluated the incidence and predictors of shoulder imbalance after selective ASF for Lenke type 5C AIS. Methods: In total, 62 patients with Lenke type 5C AIS (4 men and 58 women, mean age at surgery of 15.5 ± 1.5 years) were included and divided into the following two groups according to the radiographic shoulder height (RSH) at the final follow-up: PSI and non-PSI groups. All patients in this study underwent a whole-spine radiological evaluation. Various spinal coronal and sagittal profiles on radiographs were compared between the 2 groups. The clinical outcomes were assessed using the Scoliosis Research Society (SRS)-22 questionnaires. Results: The mean final follow-up duration was 8.6 ± 2.7 years. PSI was observed in 10 patients (16.1%) immediately after surgery; however, in the long-term follow-up period, PSI improved in 3 patients spontaneously, whereas the remaining 7 patients had residual PSI. The preoperative RSH and correction rates of the major curve immediately after surgery or at the final follow-up were significantly larger in the PSI group than in the non-PSI group (p=.001, p=.023, and p=.019, respectively). Receiver operating characteristic curve analysis indicated that the cutoff values for preoperative RSH and the correction rates immediately after surgery and at the final follow-up were 11.79 mm (p=.002; area under the curve [AUC], 0.948), 71.0% (p=.026; AUC, 0.822), and 65.4% (p=.021; AUC, 0.835), respectively. No statistically significant difference was observed in the preoperative and final follow-up SRS-22 scores in any domain between the PSI and non-PSI groups. Conclusions: Paying attention to the preoperative RSH and avoiding excessive correction of the major curve can prevent the occurrence of shoulder imbalance after selective ASF for Lenke type 5C AIS.http://www.sciencedirect.com/science/article/pii/S2666548423000057Adolescent idiopathic scoliosisLenke type 5cPostoperative shoulder imbalanceRadiographic shoulder heightT1 tiltClavicle angle |
| spellingShingle | Toshiki Okubo, MD, PhD Tsunehiko Konomi, MD, PhD Yoshihide Yanai, MD Yoshiomi Kobayashi, MD, PhD Mitsuru Furukawa, MD, PhD Kanehiro Fujiyoshi, MD, PhD Takashi Asazuma, MD, PhD Yoshiyuki Yato, MD, PhD Incidence and predictive factors of shoulder imbalance after selective anterior spinal fusion surgery in Lenke type 5C adolescent idiopathic scoliosis North American Spine Society Journal Adolescent idiopathic scoliosis Lenke type 5c Postoperative shoulder imbalance Radiographic shoulder height T1 tilt Clavicle angle |
| title | Incidence and predictive factors of shoulder imbalance after selective anterior spinal fusion surgery in Lenke type 5C adolescent idiopathic scoliosis |
| title_full | Incidence and predictive factors of shoulder imbalance after selective anterior spinal fusion surgery in Lenke type 5C adolescent idiopathic scoliosis |
| title_fullStr | Incidence and predictive factors of shoulder imbalance after selective anterior spinal fusion surgery in Lenke type 5C adolescent idiopathic scoliosis |
| title_full_unstemmed | Incidence and predictive factors of shoulder imbalance after selective anterior spinal fusion surgery in Lenke type 5C adolescent idiopathic scoliosis |
| title_short | Incidence and predictive factors of shoulder imbalance after selective anterior spinal fusion surgery in Lenke type 5C adolescent idiopathic scoliosis |
| title_sort | incidence and predictive factors of shoulder imbalance after selective anterior spinal fusion surgery in lenke type 5c adolescent idiopathic scoliosis |
| topic | Adolescent idiopathic scoliosis Lenke type 5c Postoperative shoulder imbalance Radiographic shoulder height T1 tilt Clavicle angle |
| url | http://www.sciencedirect.com/science/article/pii/S2666548423000057 |
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