Postoperative neck tilt in Lenke 1 and 2 AIS patients after correction surgery: a novel predictive index
Abstract Background Postoperative neck tilt (PNT) is a phenomenon in adolescent idiopathic scoliosis (AIS) patients which is distinct form shoulder imbalance. There were scarce studies performed to explore the risk factors for PNT in Lenke 1 and 2 AIS patients, and whether it can be predicted after...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-09-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12891-019-2792-9 |
| _version_ | 1819051388265562112 |
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| author | Yilin Yang Mingyuan Yang Zongde Yang Kai Chen Jinyi Bai Jian Zhao Haijian Ni Changwei Yang Ming Li |
| author_facet | Yilin Yang Mingyuan Yang Zongde Yang Kai Chen Jinyi Bai Jian Zhao Haijian Ni Changwei Yang Ming Li |
| author_sort | Yilin Yang |
| collection | DOAJ |
| description | Abstract Background Postoperative neck tilt (PNT) is a phenomenon in adolescent idiopathic scoliosis (AIS) patients which is distinct form shoulder imbalance. There were scarce studies performed to explore the risk factors for PNT in Lenke 1 and 2 AIS patients, and whether it can be predicted after surgery remains unknown. The objective of this study is to explore the prevalence and risk factors for PNT, and introduce an index for prediction of PNT in Lenke 1 and 2 AIS patients after correction surgery. Methods Medical records of Lenke 1 and 2 AIS patients who received correction surgery were reviewed from February 2013 to February 2015. Posteroanterior films were evaluated before surgery and at 2 years’ follow-up. Patients were divided into two groups according to whether PNT occurred at the 2 years’ follow-up. Risk factors of PNT were analyzed, and PNT Index was proposed and verified. Results One hundred two Lenke 1 and 2 AIS patients were recruited in this study. The prevalence of PNT after correction was 40.2%. According to the postoperative CAT (Cervical Axis Tilt), patients were divided into two group: PNT group (CAT≧5°, n = 41) and non-PNT group (CAT< 5°, n = 61). Postoperative T1 tilt, preoperative proximal thoracic curve (PTC), postoperative PTC and postoperative coronal balance (CB) were significantly different between two groups. Logistic regression showed that postoperative PTC and postoperative CB were the primary risk factors for PNT, which could be predicted by the regression equation: PNT Index = 1.1 x postoperative PTC (degrees) - 0.9 x postoperative CB (millimeters). On the basis of ROC curve, if PNT Index was more than 10, the occurrence rate of PNT was 86%. On the contrary, the rate of no PNT phenomenon was 80%. Conclusion Postoperative PTC and postoperative CB were the important factors for PNT in Lenke 1 and 2 AIS patients. Sufficient correction of PTC and moderate correction of CB should be recommended when operating on Lenke1 and 2 AIS patients. |
| first_indexed | 2024-12-21T12:03:09Z |
| format | Article |
| id | doaj.art-bf59b05795ce4e17bc3fef38bd09d7bd |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-21T12:03:09Z |
| publishDate | 2019-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-bf59b05795ce4e17bc3fef38bd09d7bd2022-12-21T19:04:46ZengBMCBMC Musculoskeletal Disorders1471-24742019-09-012011910.1186/s12891-019-2792-9Postoperative neck tilt in Lenke 1 and 2 AIS patients after correction surgery: a novel predictive indexYilin Yang0Mingyuan Yang1Zongde Yang2Kai Chen3Jinyi Bai4Jian Zhao5Haijian Ni6Changwei Yang7Ming Li8Department of Orthopedics, Changhai Hospital, Second Military Medical UniversityDepartment of Orthopedics, Changhai Hospital, Second Military Medical UniversityDepartment of Orthopedics, Changhai Hospital, Second Military Medical UniversityDepartment of Orthopedics, Changhai Hospital, Second Military Medical UniversityDepartment of Orthopedics, Changhai Hospital, Second Military Medical UniversityDepartment of Orthopedics, Changhai Hospital, Second Military Medical UniversityDepartment of Orthopedics, Shanghai 10th people’s hospital, Tongji UniversityDepartment of Orthopedics, Changhai Hospital, Second Military Medical UniversityDepartment of Orthopedics, Changhai Hospital, Second Military Medical UniversityAbstract Background Postoperative neck tilt (PNT) is a phenomenon in adolescent idiopathic scoliosis (AIS) patients which is distinct form shoulder imbalance. There were scarce studies performed to explore the risk factors for PNT in Lenke 1 and 2 AIS patients, and whether it can be predicted after surgery remains unknown. The objective of this study is to explore the prevalence and risk factors for PNT, and introduce an index for prediction of PNT in Lenke 1 and 2 AIS patients after correction surgery. Methods Medical records of Lenke 1 and 2 AIS patients who received correction surgery were reviewed from February 2013 to February 2015. Posteroanterior films were evaluated before surgery and at 2 years’ follow-up. Patients were divided into two groups according to whether PNT occurred at the 2 years’ follow-up. Risk factors of PNT were analyzed, and PNT Index was proposed and verified. Results One hundred two Lenke 1 and 2 AIS patients were recruited in this study. The prevalence of PNT after correction was 40.2%. According to the postoperative CAT (Cervical Axis Tilt), patients were divided into two group: PNT group (CAT≧5°, n = 41) and non-PNT group (CAT< 5°, n = 61). Postoperative T1 tilt, preoperative proximal thoracic curve (PTC), postoperative PTC and postoperative coronal balance (CB) were significantly different between two groups. Logistic regression showed that postoperative PTC and postoperative CB were the primary risk factors for PNT, which could be predicted by the regression equation: PNT Index = 1.1 x postoperative PTC (degrees) - 0.9 x postoperative CB (millimeters). On the basis of ROC curve, if PNT Index was more than 10, the occurrence rate of PNT was 86%. On the contrary, the rate of no PNT phenomenon was 80%. Conclusion Postoperative PTC and postoperative CB were the important factors for PNT in Lenke 1 and 2 AIS patients. Sufficient correction of PTC and moderate correction of CB should be recommended when operating on Lenke1 and 2 AIS patients.http://link.springer.com/article/10.1186/s12891-019-2792-9Postoperative neck tiltRisk factorsPredictive index |
| spellingShingle | Yilin Yang Mingyuan Yang Zongde Yang Kai Chen Jinyi Bai Jian Zhao Haijian Ni Changwei Yang Ming Li Postoperative neck tilt in Lenke 1 and 2 AIS patients after correction surgery: a novel predictive index BMC Musculoskeletal Disorders Postoperative neck tilt Risk factors Predictive index |
| title | Postoperative neck tilt in Lenke 1 and 2 AIS patients after correction surgery: a novel predictive index |
| title_full | Postoperative neck tilt in Lenke 1 and 2 AIS patients after correction surgery: a novel predictive index |
| title_fullStr | Postoperative neck tilt in Lenke 1 and 2 AIS patients after correction surgery: a novel predictive index |
| title_full_unstemmed | Postoperative neck tilt in Lenke 1 and 2 AIS patients after correction surgery: a novel predictive index |
| title_short | Postoperative neck tilt in Lenke 1 and 2 AIS patients after correction surgery: a novel predictive index |
| title_sort | postoperative neck tilt in lenke 1 and 2 ais patients after correction surgery a novel predictive index |
| topic | Postoperative neck tilt Risk factors Predictive index |
| url | http://link.springer.com/article/10.1186/s12891-019-2792-9 |
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