Comparison of surgical outcomes of lenke type 1B idiopathic scoliosis; selective or not selective


Akgül T. , Salduz A. , Bayram S. , Korkmaz M., Şar C.

XIIth International Turkish Spine Congress , Antalya, Türkiye, 19 Nisan 2017, ss.126

  • Basıldığı Şehir: Antalya
  • Basıldığı Ülke: Türkiye
  • Sayfa Sayıları: ss.126

Özet

AMAÇ: To evaluate the effects of selective or nonselective fusion on the sagittal parameters of Lenke type 1B AIS patients undergo posterior instrumentation and fusion. YÖNTEM: 22 patients with AIS were included the study. The fusion levels were decided according to the Lenke criteria. As selective or not selective fusion. Only lenke type 1B AIS operated at university hospital between from 2008 to 2012 were included the study. All patient operated by the one senior surgeon. Deformity correction was performed with segmental vertebral translation using polyaxial pedicle screw. Patients were classified according to fusion level as Group 1(11 pts) selective fusion and Group 2 (11 pts) nonselective fusion. Radiological examination was performed on standart lateral and posterior anterior columna vertebralis xray was taken on long cassette. Cobb angle, Coronal (CSVL) and sagittal balance (SVA), Thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI) , sacral slope (SS), and pelvic tilt (PT) was measured. BULGULAR: The mean age was 14+/-2.1 years and mean follow-up was 44,27±11,69 months. The cobb angle of deformity changed 51+/- 10 degrees to 8,3+/- 3,6 at each group (p=0,00) and no difference between two groups. TK changed 23,5+/- 9,3 degrees to 21,7+/- 6,3, (p=0,16) LL changed 56,5+/- 10,9 degrees to 51,7 +/-8,3 degrees (p=0,082). İn non-selective fusion group TK values drop from 25,6+/-9,8 to 22,2+/-8,6 (p=0,02). PI levels to drop from 47,5±12,4 degrees to 47,5±9,0 (p=0,01). PT changed from 11+/-10 to 12+/-7,5. While SS dropped from 37,4+/-11,3 degrees to 36,2+/-6,9 degrees, no difference was observed within or among groups (P=0,81, p=0,54, p=0,35). CSVL was 3,53 +/-3,3 mm pre-op, and 4,2+/-3,3 mm post-op (p=0,455). The difference was founded between two groups on coronal balance (p=0013).The mean fusion levels were 12 +/- 0,4 in non selective group and 9,6+/- 0,2 in selective group. SONUÇ: The selective or nonselective fusion in treatment of Lenke Type 1B AIS have similar results in lumbar and pelvic parameter. Non selective group have better results on thoracal kyphosis restoration and coronal balance compared the selective group.