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Conference Paper: Prediction of scoliosis correction with thoracic segmental pedicle screw constructs using fulcrum bending radiographs

TitlePrediction of scoliosis correction with thoracic segmental pedicle screw constructs using fulcrum bending radiographs
Authors
KeywordsFulcrum bending radiograph
Scoliosis correction
Thoracic pedicle screw
Issue Date2010
PublisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.com
Citation
The 29th Annual Congress of the Hong Kong Orthopaedic Association, Hong Kong, 28-29 November 2009. In Spine, 2010, v. 35 n. 5, p. 557-561 How to Cite?
AbstractStudy Design: A retrospective series of 35 idiopathic scoliosis patients underwent spinal fusion with a segmental thoracic pedicle screw system. Objective: To evaluate the amount of scoliosis correction with segmental pedicle screw constructs, and assess whether the fulcrum bending radiograph can predict surgical correction. Summary of Background Data: The fulcrum bending radiograph is highly predictive of actual curve correction based on hook or hybrid systems. However, its predictive value in segmental pedicle screw fixation systems has not been reported. Methods: Patients diagnosed with Lenke type 1A and 1B thoracic idiopathic scoliosis who underwent posterior spinal fusion with segmental pedicle screw constructs by single surgeon from January 2000 to December 2005 were reviewed. The fulcrum flexibility rate (FFR) and correction rate were compared. Stepwise linear regression analysis was done and a prediction equation for the postoperative Cobb angle was developed. Results: Thirty-five consecutive patients were included. Age at surgery was 14.8 years. Twenty scoliosis deformities were flexible, 15 were rigid. All patients had at least 2-year follow-up. The average preoperative Cobb angle was 58°, fulcrum bending Cobb angle was 28°, and postoperative Cobb angle 15° and 16° at 1 month and 2 years, respectively, after surgery. There was significant difference between FFR (51%) and correction rate at 1 month (72%) and 2 year (70%) after surgery. The difference between fulcrum bending corrective index of flexible (122%) and rigid (203%) curves was statistically significant. Stepwise linear regression analysis showed: Predicted postoperative Cobb angle = 0.012 + 1.75 × age - 0.212 × FFR (R = 0.69, P < 0.01). Conclusion: Thoracic pedicle screw constructs achieved better scoliosis correction compared with fulcrum bending radiographs. The fulcrum bending corrective index achieved was significantly greater in rigid than flexible curves. The postoperative Cobb angles could be calculated with a predictive equation. © 2010, Lippincott Williams & Wilkins.
DescriptionAward Papers Session: A2
Persistent Identifierhttp://hdl.handle.net/10722/126512
ISSN
2015 Impact Factor: 2.439
2015 SCImago Journal Rankings: 1.459
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorCheung, WYen_HK
dc.contributor.authorLenke, LGen_HK
dc.contributor.authorLuk, KDKen_HK
dc.date.accessioned2010-10-31T12:32:59Z-
dc.date.available2010-10-31T12:32:59Z-
dc.date.issued2010en_HK
dc.identifier.citationThe 29th Annual Congress of the Hong Kong Orthopaedic Association, Hong Kong, 28-29 November 2009. In Spine, 2010, v. 35 n. 5, p. 557-561en_HK
dc.identifier.issn0362-2436en_HK
dc.identifier.urihttp://hdl.handle.net/10722/126512-
dc.descriptionAward Papers Session: A2-
dc.description.abstractStudy Design: A retrospective series of 35 idiopathic scoliosis patients underwent spinal fusion with a segmental thoracic pedicle screw system. Objective: To evaluate the amount of scoliosis correction with segmental pedicle screw constructs, and assess whether the fulcrum bending radiograph can predict surgical correction. Summary of Background Data: The fulcrum bending radiograph is highly predictive of actual curve correction based on hook or hybrid systems. However, its predictive value in segmental pedicle screw fixation systems has not been reported. Methods: Patients diagnosed with Lenke type 1A and 1B thoracic idiopathic scoliosis who underwent posterior spinal fusion with segmental pedicle screw constructs by single surgeon from January 2000 to December 2005 were reviewed. The fulcrum flexibility rate (FFR) and correction rate were compared. Stepwise linear regression analysis was done and a prediction equation for the postoperative Cobb angle was developed. Results: Thirty-five consecutive patients were included. Age at surgery was 14.8 years. Twenty scoliosis deformities were flexible, 15 were rigid. All patients had at least 2-year follow-up. The average preoperative Cobb angle was 58°, fulcrum bending Cobb angle was 28°, and postoperative Cobb angle 15° and 16° at 1 month and 2 years, respectively, after surgery. There was significant difference between FFR (51%) and correction rate at 1 month (72%) and 2 year (70%) after surgery. The difference between fulcrum bending corrective index of flexible (122%) and rigid (203%) curves was statistically significant. Stepwise linear regression analysis showed: Predicted postoperative Cobb angle = 0.012 + 1.75 × age - 0.212 × FFR (R = 0.69, P < 0.01). Conclusion: Thoracic pedicle screw constructs achieved better scoliosis correction compared with fulcrum bending radiographs. The fulcrum bending corrective index achieved was significantly greater in rigid than flexible curves. The postoperative Cobb angles could be calculated with a predictive equation. © 2010, Lippincott Williams & Wilkins.en_HK
dc.languageengen_HK
dc.publisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.comen_HK
dc.relation.ispartofSpineen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.rightsThis is a non-final version of an article published in final form in Spine, 2010, v. 35 n. 5, p. 557-561-
dc.subjectFulcrum bending radiographen_HK
dc.subjectScoliosis correctionen_HK
dc.subjectThoracic pedicle screwen_HK
dc.subject.meshAdolescent-
dc.subject.meshBone Screws-
dc.subject.meshScoliosis - radiography - surgery-
dc.subject.meshSpinal Fusion - instrumentation - methods-
dc.subject.meshThoracic Vertebrae - radiography - surgery-
dc.titlePrediction of scoliosis correction with thoracic segmental pedicle screw constructs using fulcrum bending radiographsen_HK
dc.typeConference_Paperen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0362-2436&volume=35&issue=5&spage=557&epage=561&date=2010&atitle=Prediction+of+scoliosis+correction+with+thoracic+segmental+pedicle+screw+constructs+using+fulcrum+bending+radiographs-
dc.identifier.emailLuk, KDK:hcm21000@hku.hken_HK
dc.identifier.authorityLuk, KDK=rp00333en_HK
dc.description.naturepostprint-
dc.identifier.doi10.1097/BRS.0b013e3181b9cfa9en_HK
dc.identifier.pmid20118839-
dc.identifier.scopuseid_2-s2.0-77649291202en_HK
dc.identifier.hkuros180243en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77649291202&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume35en_HK
dc.identifier.issue5en_HK
dc.identifier.spage557en_HK
dc.identifier.epage561en_HK
dc.identifier.isiWOS:000275324000014-
dc.publisher.placeUnited Statesen_HK
dc.description.otherThe 29th Annual Congress of the Hong Kong Orthopaedic Association, Hong Kong, 28-29 November 2009. In Spine, 2010, v. 35 n. 5, p. 557-561-
dc.identifier.scopusauthoridCheung, WY=24504264600en_HK
dc.identifier.scopusauthoridLenke, LG=7102707092en_HK
dc.identifier.scopusauthoridLuk, KDK=7201921573en_HK

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