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Article: Coronal deformity correction in adolescent idiopathic scoliosis patients using the fulcrum-bending radiograph: A prospective comparative analysis of the proximal thoracic, main thoracic, and thoracolumbar/lumbar curves

TitleCoronal deformity correction in adolescent idiopathic scoliosis patients using the fulcrum-bending radiograph: A prospective comparative analysis of the proximal thoracic, main thoracic, and thoracolumbar/lumbar curves
Authors
KeywordsAdolescent idiopathic scoliosis
Flexibility
Fulcrum-bending radiograph
Fusion
Radiograph
Spine
Issue Date2011
PublisherSpringer. The Journal's web site is located at http://www.springer.com/medicine/orthopedics/journal/586
Citation
European Spine Journal, 2011, v. 20 n. 1, p. 105-111 How to Cite?
AbstractThe aim of the prospective, comparative radiographic analysis was to determine the role of the fulcrum-bending radiograph (FBR) for the assessment of the proximal thoracic (PT), main thoracic (MT), and the thoracolumbar/lumbar (TL/L) curves in patients undergoing posterior spinal pedicle screw fixation and fusion for adolescent idiopathic scoliosis (AIS). The FBR demonstrated statistically better correction than other preoperative methods for the assessment of frontal plane correction of the MT curves. The fulcrum-bending correction index (FBCI) has been considered a superior method than the correction rate for comparing curve correction undergoing posterior spinal fusion because it accounts for the curve flexibility. However, their applicability to assess the PT and TL/L curves in AIS patients remains speculative. The relation between FBR and correction obtained by pedicle screws fixation is still unknown. Thirty-eight consecutive AIS patients who underwent pedicle screw fixation and posterior fusion were included in this study. The assessment of preoperative radiographs included standing posterior-anterior (PA), FBR, supine side-bending, and postoperative standing PA and lateral plain radiographs. The flexibility of the curve, as well as the FBCI, was calculated for all patients. Postoperatively, radiographs were assessed at immediate (i.e. 1 week), 3-month, 6-month, 12-month, and 2-year follow-up. Cobb angles were obtained from the PT, MT, and TL/L curves. The study consisted of 9 PT, 37 MT, and 12 TL/L curves, with a mean age of 15.1 years. The mean FBR flexibility of the PT, MT, and the TL/L curves was 42.6, 61.1, and 66.2%, respectively. The mean operative correction rates in the PT, MT, and TL/L curves were 43.4, 69.3, and 73.9%, respectively, and the mean FBCI was 103.8, 117.0, and 114.8%, respectively. Fulcrum-bending flexibility was positively correlated with the operative correction rate in PT, MT, and TL/L curves. Although the correction rate in MT and TL/L curves was higher than PT curves, the FBCI in PT, MT, and TL/L curves was not significantly different (p < 0.05). The FBR can be used to assist in the assessment of PT, MT, and TL/L curve corrections in AIS patients. When curve flexibility is taken into account by FBR, the ability of pedicle screws to correct PT, MT, and TL/L curves is the same. © 2010 Springer-Verlag.
Persistent Identifierhttp://hdl.handle.net/10722/92894
ISSN
2015 Impact Factor: 2.132
2015 SCImago Journal Rankings: 0.972
PubMed Central ID
ISI Accession Number ID
Funding AgencyGrant Number
Depuy Spine
Funding Information:

The device(s)/drug(s) are FDA-approved or approved by a corresponding national agency for this indication. No sources of funding were received in relation to this work. The authors have no financial or competing interests in relation to this work. However, both Dr. Albert and Dr. Vaccaro are consultants and receive royalties on spinal products of Depuy Spine.

References

 

DC FieldValueLanguage
dc.contributor.authorLi, Jen_HK
dc.contributor.authorDumonski, MLen_HK
dc.contributor.authorSamartzis, Den_HK
dc.contributor.authorHong, Jen_HK
dc.contributor.authorHe, Sen_HK
dc.contributor.authorZhu, Xen_HK
dc.contributor.authorWang, Cen_HK
dc.contributor.authorVaccaro, ARen_HK
dc.contributor.authorAlbert, TJen_HK
dc.contributor.authorLi, Men_HK
dc.date.accessioned2010-09-22T05:03:00Z-
dc.date.available2010-09-22T05:03:00Z-
dc.date.issued2011en_HK
dc.identifier.citationEuropean Spine Journal, 2011, v. 20 n. 1, p. 105-111en_HK
dc.identifier.issn0940-6719en_HK
dc.identifier.urihttp://hdl.handle.net/10722/92894-
dc.description.abstractThe aim of the prospective, comparative radiographic analysis was to determine the role of the fulcrum-bending radiograph (FBR) for the assessment of the proximal thoracic (PT), main thoracic (MT), and the thoracolumbar/lumbar (TL/L) curves in patients undergoing posterior spinal pedicle screw fixation and fusion for adolescent idiopathic scoliosis (AIS). The FBR demonstrated statistically better correction than other preoperative methods for the assessment of frontal plane correction of the MT curves. The fulcrum-bending correction index (FBCI) has been considered a superior method than the correction rate for comparing curve correction undergoing posterior spinal fusion because it accounts for the curve flexibility. However, their applicability to assess the PT and TL/L curves in AIS patients remains speculative. The relation between FBR and correction obtained by pedicle screws fixation is still unknown. Thirty-eight consecutive AIS patients who underwent pedicle screw fixation and posterior fusion were included in this study. The assessment of preoperative radiographs included standing posterior-anterior (PA), FBR, supine side-bending, and postoperative standing PA and lateral plain radiographs. The flexibility of the curve, as well as the FBCI, was calculated for all patients. Postoperatively, radiographs were assessed at immediate (i.e. 1 week), 3-month, 6-month, 12-month, and 2-year follow-up. Cobb angles were obtained from the PT, MT, and TL/L curves. The study consisted of 9 PT, 37 MT, and 12 TL/L curves, with a mean age of 15.1 years. The mean FBR flexibility of the PT, MT, and the TL/L curves was 42.6, 61.1, and 66.2%, respectively. The mean operative correction rates in the PT, MT, and TL/L curves were 43.4, 69.3, and 73.9%, respectively, and the mean FBCI was 103.8, 117.0, and 114.8%, respectively. Fulcrum-bending flexibility was positively correlated with the operative correction rate in PT, MT, and TL/L curves. Although the correction rate in MT and TL/L curves was higher than PT curves, the FBCI in PT, MT, and TL/L curves was not significantly different (p < 0.05). The FBR can be used to assist in the assessment of PT, MT, and TL/L curve corrections in AIS patients. When curve flexibility is taken into account by FBR, the ability of pedicle screws to correct PT, MT, and TL/L curves is the same. © 2010 Springer-Verlag.en_HK
dc.languageengen_HK
dc.publisherSpringer. The Journal's web site is located at http://www.springer.com/medicine/orthopedics/journal/586en_HK
dc.relation.ispartofEuropean Spine Journalen_HK
dc.subjectAdolescent idiopathic scoliosisen_HK
dc.subjectFlexibilityen_HK
dc.subjectFulcrum-bending radiographen_HK
dc.subjectFusionen_HK
dc.subjectRadiographen_HK
dc.subjectSpineen_HK
dc.titleCoronal deformity correction in adolescent idiopathic scoliosis patients using the fulcrum-bending radiograph: A prospective comparative analysis of the proximal thoracic, main thoracic, and thoracolumbar/lumbar curvesen_HK
dc.typeArticleen_HK
dc.identifier.emailSamartzis, D:dspine@hku.hken_HK
dc.identifier.authoritySamartzis, D=rp01430en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s00586-010-1495-6en_HK
dc.identifier.pmid20700611-
dc.identifier.pmcidPMC3036022-
dc.identifier.scopuseid_2-s2.0-78651477734en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-78651477734&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume20en_HK
dc.identifier.issue1en_HK
dc.identifier.spage105en_HK
dc.identifier.epage111en_HK
dc.identifier.eissn1432-0932-
dc.identifier.isiWOS:000285972500014-
dc.publisher.placeGermanyen_HK
dc.identifier.scopusauthoridLi, J=7410072934en_HK
dc.identifier.scopusauthoridDumonski, ML=6506618619en_HK
dc.identifier.scopusauthoridSamartzis, D=34572771100en_HK
dc.identifier.scopusauthoridHong, J=35885566300en_HK
dc.identifier.scopusauthoridHe, S=12042341600en_HK
dc.identifier.scopusauthoridZhu, X=35104235900en_HK
dc.identifier.scopusauthoridWang, C=25936879600en_HK
dc.identifier.scopusauthoridVaccaro, AR=7102519424en_HK
dc.identifier.scopusauthoridAlbert, TJ=35451010100en_HK
dc.identifier.scopusauthoridLi, M=36067789100en_HK
dc.identifier.citeulike7704588-

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