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Influence of Lateral Translation of Lowest Instrumented Vertebra on L4 Tilt and Coronal Balance for Thoracolumbar and Lumbar Curves in Adolescent Idiopathic Scoliosis

This study aimed to evaluate the lowest instrumented vertebra translation (LIV-T) in the surgical treatment of thoracolumbar/lumbar adolescent idiopathic scoliosis and to analyze the radiographic parameters in relation to LIV-T and L4 tilt and global coronal balance. A total of 62 patients underwent...

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Autores principales: Yamada, Katsuhisa, Sudo, Hideki, Abe, Yuichiro, Kokabu, Terufumi, Tachi, Hiroyuki, Endo, Tsutomu, Ohnishi, Takashi, Ukeba, Daisuke, Ura, Katsuro, Takahata, Masahiko, Iwasaki, Norimasa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9961343/
https://www.ncbi.nlm.nih.gov/pubmed/36835925
http://dx.doi.org/10.3390/jcm12041389
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author Yamada, Katsuhisa
Sudo, Hideki
Abe, Yuichiro
Kokabu, Terufumi
Tachi, Hiroyuki
Endo, Tsutomu
Ohnishi, Takashi
Ukeba, Daisuke
Ura, Katsuro
Takahata, Masahiko
Iwasaki, Norimasa
author_facet Yamada, Katsuhisa
Sudo, Hideki
Abe, Yuichiro
Kokabu, Terufumi
Tachi, Hiroyuki
Endo, Tsutomu
Ohnishi, Takashi
Ukeba, Daisuke
Ura, Katsuro
Takahata, Masahiko
Iwasaki, Norimasa
author_sort Yamada, Katsuhisa
collection PubMed
description This study aimed to evaluate the lowest instrumented vertebra translation (LIV-T) in the surgical treatment of thoracolumbar/lumbar adolescent idiopathic scoliosis and to analyze the radiographic parameters in relation to LIV-T and L4 tilt and global coronal balance. A total of 62 patients underwent posterior spinal fusion (PSF, n = 32) or anterior spinal fusion (ASF, n = 30) and were followed up for a minimum of 2 years. The mean preoperative LIV-T was significantly larger in the ASF group than the PSF (p < 0.01), while the final LIV-T was equivalent. LIV-T at the final follow-up was significantly correlated with L4 tilt and the global coronal balance (r = 0.69, p < 0.01, r = 0.38, p < 0.01, respectively). Receiver-operating characteristic analysis for good outcomes, with L4 tilt <8° and coronal balance <15 mm at the final follow-up, calculated the cutoff value of the final LIV-T as 12 mm. The cutoff value of preoperative LIV-T that would result in the LIV-T of ≤12 mm at the final follow-up was 32 mm in PSF, although no significant cutoff value was calculated in ASF. ASF can centralize the LIV better than PSF with a shorter segment fusion, and could be useful in obtaining a good curve correction and global balance without fixation to L4 in cases with large preoperative LIV-T.
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spelling pubmed-99613432023-02-26 Influence of Lateral Translation of Lowest Instrumented Vertebra on L4 Tilt and Coronal Balance for Thoracolumbar and Lumbar Curves in Adolescent Idiopathic Scoliosis Yamada, Katsuhisa Sudo, Hideki Abe, Yuichiro Kokabu, Terufumi Tachi, Hiroyuki Endo, Tsutomu Ohnishi, Takashi Ukeba, Daisuke Ura, Katsuro Takahata, Masahiko Iwasaki, Norimasa J Clin Med Article This study aimed to evaluate the lowest instrumented vertebra translation (LIV-T) in the surgical treatment of thoracolumbar/lumbar adolescent idiopathic scoliosis and to analyze the radiographic parameters in relation to LIV-T and L4 tilt and global coronal balance. A total of 62 patients underwent posterior spinal fusion (PSF, n = 32) or anterior spinal fusion (ASF, n = 30) and were followed up for a minimum of 2 years. The mean preoperative LIV-T was significantly larger in the ASF group than the PSF (p < 0.01), while the final LIV-T was equivalent. LIV-T at the final follow-up was significantly correlated with L4 tilt and the global coronal balance (r = 0.69, p < 0.01, r = 0.38, p < 0.01, respectively). Receiver-operating characteristic analysis for good outcomes, with L4 tilt <8° and coronal balance <15 mm at the final follow-up, calculated the cutoff value of the final LIV-T as 12 mm. The cutoff value of preoperative LIV-T that would result in the LIV-T of ≤12 mm at the final follow-up was 32 mm in PSF, although no significant cutoff value was calculated in ASF. ASF can centralize the LIV better than PSF with a shorter segment fusion, and could be useful in obtaining a good curve correction and global balance without fixation to L4 in cases with large preoperative LIV-T. MDPI 2023-02-09 /pmc/articles/PMC9961343/ /pubmed/36835925 http://dx.doi.org/10.3390/jcm12041389 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Yamada, Katsuhisa
Sudo, Hideki
Abe, Yuichiro
Kokabu, Terufumi
Tachi, Hiroyuki
Endo, Tsutomu
Ohnishi, Takashi
Ukeba, Daisuke
Ura, Katsuro
Takahata, Masahiko
Iwasaki, Norimasa
Influence of Lateral Translation of Lowest Instrumented Vertebra on L4 Tilt and Coronal Balance for Thoracolumbar and Lumbar Curves in Adolescent Idiopathic Scoliosis
title Influence of Lateral Translation of Lowest Instrumented Vertebra on L4 Tilt and Coronal Balance for Thoracolumbar and Lumbar Curves in Adolescent Idiopathic Scoliosis
title_full Influence of Lateral Translation of Lowest Instrumented Vertebra on L4 Tilt and Coronal Balance for Thoracolumbar and Lumbar Curves in Adolescent Idiopathic Scoliosis
title_fullStr Influence of Lateral Translation of Lowest Instrumented Vertebra on L4 Tilt and Coronal Balance for Thoracolumbar and Lumbar Curves in Adolescent Idiopathic Scoliosis
title_full_unstemmed Influence of Lateral Translation of Lowest Instrumented Vertebra on L4 Tilt and Coronal Balance for Thoracolumbar and Lumbar Curves in Adolescent Idiopathic Scoliosis
title_short Influence of Lateral Translation of Lowest Instrumented Vertebra on L4 Tilt and Coronal Balance for Thoracolumbar and Lumbar Curves in Adolescent Idiopathic Scoliosis
title_sort influence of lateral translation of lowest instrumented vertebra on l4 tilt and coronal balance for thoracolumbar and lumbar curves in adolescent idiopathic scoliosis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9961343/
https://www.ncbi.nlm.nih.gov/pubmed/36835925
http://dx.doi.org/10.3390/jcm12041389
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