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Anterior versus posterior approach in Lenke type 1 adolescent idiopathic scoliosis: a comparison of long-term follow-up outcomes
BACKGROUND: After surgical treatment of adolescent idiopathic scoliosis (AIS), doctors should not only focus on the short-term surgical effect, but also pay special attention to whether the patients can live normally in the long-term. This work compared the long-term effects of thoracoscopy-assisted...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9073785/ https://www.ncbi.nlm.nih.gov/pubmed/35530929 http://dx.doi.org/10.21037/atm-22-573 |
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author | Gu, Haowen Li, Yawei Dai, Yuliang Wang, Bing |
author_facet | Gu, Haowen Li, Yawei Dai, Yuliang Wang, Bing |
author_sort | Gu, Haowen |
collection | PubMed |
description | BACKGROUND: After surgical treatment of adolescent idiopathic scoliosis (AIS), doctors should not only focus on the short-term surgical effect, but also pay special attention to whether the patients can live normally in the long-term. This work compared the long-term effects of thoracoscopy-assisted anterior spinal fusion (ASF) and posterior spinal fusion (PSF) in AIS. METHODS: Twenty-two patients underwent thoracoscopy-assisted ASF, and twenty-three patients underwent PSF from 2004 to 2009 were involved , including 14 males and 31 females with an average age of 14.8±2.6 years, and all patients suffered from only Lenke type 1 AIS. The mean follow-up time was 102 months, the radiographic parameters and operation time, hospitalization time, fusion segments and estimated blood loss were evaluated. Comparisons between groups were made such as Cobb’s angle, thoracic kyphosis, the instrumented levels, curve correction, preoperative parameters, SF-36/SRS-22 questionnaire scores, and pulmonary function. RESULTS: There was no significant difference in age, gender, Risser sign and follow-up period between two groups. The instrumentation level had an average of 6 in the thoracoscopy-assisted ASF group and 9.7 in the PSF group (P<0.001). The average correction rate of the main curve was 67.4% in ASF group versus 79.2% in PSF group (P>0.05). The postoperative thoracic kyphosis was 16.2°±3.9° in ASF group and 25.6°±4.4° in PSF group (P=0.023). Patients had momentous advancement in self-image, vitality and mental health in the SRS-22 and SF-36 questionnaires. Compared to preoperatively, the pulmonary function of both groups was satisfactorily improved at the final follow-up. CONCLUSIONS: Since there was no statistically significant difference in the general conditions of the two groups selected for this study, so we finally concluded that thoracoscopy-assisted ASF had a satisfactory correction rate, famous long-term radiography outcomes and desirable pulmonary function results. However, compared to PSF, it has a longer operation time, a more complicated surgical procedure and a weaker three-dimensional correction effect, and PSF has affirmative long-term outcomes, fewer complications, and satisfactory sagittal balance, all of which make PSF the standard operation to treat AIS. |
format | Online Article Text |
id | pubmed-9073785 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-90737852022-05-07 Anterior versus posterior approach in Lenke type 1 adolescent idiopathic scoliosis: a comparison of long-term follow-up outcomes Gu, Haowen Li, Yawei Dai, Yuliang Wang, Bing Ann Transl Med Original Article BACKGROUND: After surgical treatment of adolescent idiopathic scoliosis (AIS), doctors should not only focus on the short-term surgical effect, but also pay special attention to whether the patients can live normally in the long-term. This work compared the long-term effects of thoracoscopy-assisted anterior spinal fusion (ASF) and posterior spinal fusion (PSF) in AIS. METHODS: Twenty-two patients underwent thoracoscopy-assisted ASF, and twenty-three patients underwent PSF from 2004 to 2009 were involved , including 14 males and 31 females with an average age of 14.8±2.6 years, and all patients suffered from only Lenke type 1 AIS. The mean follow-up time was 102 months, the radiographic parameters and operation time, hospitalization time, fusion segments and estimated blood loss were evaluated. Comparisons between groups were made such as Cobb’s angle, thoracic kyphosis, the instrumented levels, curve correction, preoperative parameters, SF-36/SRS-22 questionnaire scores, and pulmonary function. RESULTS: There was no significant difference in age, gender, Risser sign and follow-up period between two groups. The instrumentation level had an average of 6 in the thoracoscopy-assisted ASF group and 9.7 in the PSF group (P<0.001). The average correction rate of the main curve was 67.4% in ASF group versus 79.2% in PSF group (P>0.05). The postoperative thoracic kyphosis was 16.2°±3.9° in ASF group and 25.6°±4.4° in PSF group (P=0.023). Patients had momentous advancement in self-image, vitality and mental health in the SRS-22 and SF-36 questionnaires. Compared to preoperatively, the pulmonary function of both groups was satisfactorily improved at the final follow-up. CONCLUSIONS: Since there was no statistically significant difference in the general conditions of the two groups selected for this study, so we finally concluded that thoracoscopy-assisted ASF had a satisfactory correction rate, famous long-term radiography outcomes and desirable pulmonary function results. However, compared to PSF, it has a longer operation time, a more complicated surgical procedure and a weaker three-dimensional correction effect, and PSF has affirmative long-term outcomes, fewer complications, and satisfactory sagittal balance, all of which make PSF the standard operation to treat AIS. AME Publishing Company 2022-04 /pmc/articles/PMC9073785/ /pubmed/35530929 http://dx.doi.org/10.21037/atm-22-573 Text en 2022 Annals of Translational Medicine. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Original Article Gu, Haowen Li, Yawei Dai, Yuliang Wang, Bing Anterior versus posterior approach in Lenke type 1 adolescent idiopathic scoliosis: a comparison of long-term follow-up outcomes |
title | Anterior versus posterior approach in Lenke type 1 adolescent idiopathic scoliosis: a comparison of long-term follow-up outcomes |
title_full | Anterior versus posterior approach in Lenke type 1 adolescent idiopathic scoliosis: a comparison of long-term follow-up outcomes |
title_fullStr | Anterior versus posterior approach in Lenke type 1 adolescent idiopathic scoliosis: a comparison of long-term follow-up outcomes |
title_full_unstemmed | Anterior versus posterior approach in Lenke type 1 adolescent idiopathic scoliosis: a comparison of long-term follow-up outcomes |
title_short | Anterior versus posterior approach in Lenke type 1 adolescent idiopathic scoliosis: a comparison of long-term follow-up outcomes |
title_sort | anterior versus posterior approach in lenke type 1 adolescent idiopathic scoliosis: a comparison of long-term follow-up outcomes |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9073785/ https://www.ncbi.nlm.nih.gov/pubmed/35530929 http://dx.doi.org/10.21037/atm-22-573 |
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