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Article: What determines immediate postoperative coronal balance and delayed global coronal balance after anterior spinal fusion for Lenke 5C curves?

TitleWhat determines immediate postoperative coronal balance and delayed global coronal balance after anterior spinal fusion for Lenke 5C curves?
Authors
KeywordsAIS
Adolescent idiopathic scoliosis
ASF
Lenke
5C
Issue Date2021
PublisherSpringer. The Journal's web site is located at http://www.springer.com/medicine/orthopedics/journal/586
Citation
European Spine Journal, 2021, v. 30 n. 7, p. 2007–2019 How to Cite?
AbstractPurpose: To determine the factors associated with 6-week postoperative global coronal balance and delayed global coronal balance at 2-year follow-up after anterior spinal fusion for Lenke 5C curves. Methods: A total of 124 consecutive Lenke 5C curves with minimum 2-year follow-up was studied. Radiographic parameters were studied preoperatively, 6 weeks postoperatively, and 2 years postoperatively. Coronal balance was measured by C7-CSVL and trunk shift < 20 mm. The study outcomes were patients with early coronal balance and those who had immediate imbalance but developed delayed balance. Multivariate regression analyses of associated factors were performed with cutoffs determined by receiver operating characteristic curve. Results: 31.5% patients attained global coronal balance immediate postoperatively and 89.4% of the early imbalance cases showed spontaneous coronal balance at 2-year follow-up. Increased preoperative UIV tilt (OR 1.093; p = 0.026; 95% CI: 1.011–1.182) and reduced immediate postoperative RSH difference (OR 0.963; p = 0.015; 95% CI: 0.935–0.993) were associated with immediate postoperative balance. For those with immediate imbalance, larger preoperative major Cobb angle (OR 1.226; p = 0.047; 95% CI: 1.003–1.499), less preoperative C7-CSVL (OR 0.829; p = 0.016; 95% CI: 0.712–0.966), and less immediate postoperative LIV tilt (OR 0.728; p = 0.013; 95% CI: 0.567–0.934) were associated with 2-year coronal balance. There was significant improvement in function (p = 0.006), self-image (p = 0.039) and total score domains (p = 0.014) in immediate imbalance to 2-year balance and imbalance groups. Conclusion: Successful balance is achieved with a parallel fusion mass when performing anterior spinal fusion for Lenke 5C curves. Patients should be reassured that most attain eventual coronal balance despite the early imbalance. Level of evidence Therapeutic III
Persistent Identifierhttp://hdl.handle.net/10722/299701
ISSN
2023 Impact Factor: 2.6
2023 SCImago Journal Rankings: 1.042
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorMannen, A-
dc.contributor.authorCheung, PWH-
dc.contributor.authorKawasaki, S-
dc.contributor.authorShigematsu, H-
dc.contributor.authorCheung, JPY-
dc.date.accessioned2021-05-26T03:27:51Z-
dc.date.available2021-05-26T03:27:51Z-
dc.date.issued2021-
dc.identifier.citationEuropean Spine Journal, 2021, v. 30 n. 7, p. 2007–2019-
dc.identifier.issn0940-6719-
dc.identifier.urihttp://hdl.handle.net/10722/299701-
dc.description.abstractPurpose: To determine the factors associated with 6-week postoperative global coronal balance and delayed global coronal balance at 2-year follow-up after anterior spinal fusion for Lenke 5C curves. Methods: A total of 124 consecutive Lenke 5C curves with minimum 2-year follow-up was studied. Radiographic parameters were studied preoperatively, 6 weeks postoperatively, and 2 years postoperatively. Coronal balance was measured by C7-CSVL and trunk shift < 20 mm. The study outcomes were patients with early coronal balance and those who had immediate imbalance but developed delayed balance. Multivariate regression analyses of associated factors were performed with cutoffs determined by receiver operating characteristic curve. Results: 31.5% patients attained global coronal balance immediate postoperatively and 89.4% of the early imbalance cases showed spontaneous coronal balance at 2-year follow-up. Increased preoperative UIV tilt (OR 1.093; p = 0.026; 95% CI: 1.011–1.182) and reduced immediate postoperative RSH difference (OR 0.963; p = 0.015; 95% CI: 0.935–0.993) were associated with immediate postoperative balance. For those with immediate imbalance, larger preoperative major Cobb angle (OR 1.226; p = 0.047; 95% CI: 1.003–1.499), less preoperative C7-CSVL (OR 0.829; p = 0.016; 95% CI: 0.712–0.966), and less immediate postoperative LIV tilt (OR 0.728; p = 0.013; 95% CI: 0.567–0.934) were associated with 2-year coronal balance. There was significant improvement in function (p = 0.006), self-image (p = 0.039) and total score domains (p = 0.014) in immediate imbalance to 2-year balance and imbalance groups. Conclusion: Successful balance is achieved with a parallel fusion mass when performing anterior spinal fusion for Lenke 5C curves. Patients should be reassured that most attain eventual coronal balance despite the early imbalance. Level of evidence Therapeutic III-
dc.languageeng-
dc.publisherSpringer. The Journal's web site is located at http://www.springer.com/medicine/orthopedics/journal/586-
dc.relation.ispartofEuropean Spine Journal-
dc.rightsThis version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: http://dx.doi.org/10.1007/s00586-021-06807-2-
dc.subjectAIS-
dc.subjectAdolescent idiopathic scoliosis-
dc.subjectASF-
dc.subjectLenke-
dc.subject5C-
dc.titleWhat determines immediate postoperative coronal balance and delayed global coronal balance after anterior spinal fusion for Lenke 5C curves?-
dc.typeArticle-
dc.identifier.emailCheung, PWH: gnuehcp6@hku.hk-
dc.identifier.emailCheung, JPY: cheungjp@hku.hk-
dc.identifier.authorityCheung, JPY=rp01685-
dc.description.naturepostprint-
dc.identifier.doi10.1007/s00586-021-06807-2-
dc.identifier.pmid33721065-
dc.identifier.scopuseid_2-s2.0-85102811424-
dc.identifier.hkuros322559-
dc.identifier.volume30-
dc.identifier.issue7-
dc.identifier.spage2007-
dc.identifier.epage2019-
dc.identifier.isiWOS:000629070500002-
dc.publisher.placeGermany-

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