Treatment of the proximal thoracic curve in double thoracic adolescent idiopathic scoliosis: fusion strategy and correction of shoulder imbalance


Grant Data
Project Title
Treatment of the proximal thoracic curve in double thoracic adolescent idiopathic scoliosis: fusion strategy and correction of shoulder imbalance
Principal Investigator
Dr Kwan, Kenny Yat Hong   (Principal investigator)
Co-Investigator(s)
Professor Alanay Ahmet   (Co-Investigator)
Professor Kleuver Marinus   (Co-Investigator)
Duration
24
Start Date
2016-01-01
Completion Date
2017-12-31
Amount
150000
Conference Title
Presentation Title
Keywords
Spine, Scoliosis, Surgery
Discipline
Orthopaedics/Traumatology
Panel
Medicine
Sponsor
Block Grant Earmarked for Research (104)
HKU Project Code
201510159012
Grant Type
Seed Fund for Basic Research
Funding Year
2015/2016
Status
On-going
Objectives
One of the major challenges in deciding whether the PT curves should be fused or not is that there is no demonstrated and universally accepted method of flexibility assessment of the PT curve. Thus it is not possible to predict accurately whether the PT curve will correct spontaneously if only the main thoracic curve is fused. If the PT fails to correct, shoulder imbalance will persist. Besides influencing clinical and functional outcomes, shoulder deformity contributes substantially to negative self-image, psychological stress, and concerns over body development. The purpose of this study is to compare the most commonly used flexibility radiographs, and identify one that has the best correlation with postoperative correction of the proximal thoracic curves. This will help to determine which of the double thoracic curves can undergo selection thoracic fusion only, thereby reducing the magnitude of surgery, whilst at the same time, the postoperative shoulder balance can be corrected. Based on the findings of this study, we can develop new criteria and recommendations on fusion levels in double thoracic curves. We will subsequently carry out a prospective study with clinical and radiological evaluation to verify these recommendations, and propose a modification of the current scoliosis classification.