A 10-Year Radiographic Study Comparing Anterior Versus Posterior Instrumented Spinal Fusion in Patients With Lenke Type 5 Adolescent Idiopathic Scoliosis.
Spine (Phila Pa 1976)
; 45(9): 612-620, 2020 May 01.
Article
en En
| MEDLINE
| ID: mdl-31770332
Prospective cohort study. To compare the long-term, radiographic coronal and sagittal outcomes of these two approaches at 10-year follow-up. Both anterior and posterior instrumented fusions have been found to be safe and effective treatments for Lenke 5 adolescent idiopathic scoliosis with up to 2 to 5 years of follow-up. Few studies follow patients beyond this duration. 36 patients who underwent anterior (nâ=â25) or posterior instrumented spinal fusion (nâ=â11) for Lenke 5 adolescent idiopathic scoliosis over a 4-year period were recruited and followed for 10 years. Preoperative clinical data include patient's age and age of menarche. Operative data included instrumented levels, duration of surgery, and surgical blood loss. Postoperative data included duration of hospital stay, duration of intensive care unit stay, and complications. Pre- and postoperative radiographic data collected include coronal Cobb angles for structural thoracolumbar/lumbar curves, and sagittal anglessagittal vertical axis, thoracic kyphosis, global lumbar angle, pelvic incidence, pelvic tilt, sacral slope, and upper and lower end vertebrae. Posterior surgery had a shorter operative time (Pâ<â0.010) and hospital stay (Pâ<â0.010). Coronal plane deformity improved by a mean of 74% in the anterior group and 71% in the posterior group. There was no significant change at 10 years in both groups (anterior Pâ=â0.455 and posterior Pâ=â0.325). Sagittal parameters remained unchanged. There was a higher incidence of proximal junctional kyphosis in the posterior (45%) compared to the anterior (16%) group (Pâ<â0.010). Both anterior and posterior instrumentation and fusion are successful surgeries after 10 years of follow-up. They are comparable with regards to their ability to achieve and maintain good correction of scoliotic deformities and have a low rate of pseudoarthrosis and instrument failure. Ideal sagittal parameters are maintained up to 10 years of follow-up. Level of Evidence: 3.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Escoliosis
/
Fusión Vertebral
/
Vértebras Torácicas
/
Vértebras Lumbares
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
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Female
/
Humans
Idioma:
En
Revista:
Spine (Phila Pa 1976)
Año:
2020
Tipo del documento:
Article
País de afiliación:
Singapur
Pais de publicación:
Estados Unidos