Improving shoulder balance in lenke type 2 and 4 adolescent idiopathic scoliosis: clinical advantages of a proximal thoracic concave rod technique.

IF 1.8 Q3 CLINICAL NEUROLOGY

Spine deformity Pub Date : 2025-08-14 DOI:10.1007/s43390-025-01157-1

Ibrahim Obeid, Lluís Vila, Louis Boissière, Cécile Roscop, Alice Baroncini, Yann Philippe Charles, Ferran Pellisé, Javier Pizones, Ahmet Alanay, Frank Kleinstück, Daniel Larrieu, Anouar Bourghli

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引用次数: 0

Abstract

Purpose: To evaluate a novel proximal thoracic concave rod (PTCR) technique for improving postoperative shoulder imbalance (SI) in adolescent idiopathic scoliosis (AIS) patients with Lenke types 2 and 4 curves, compared to conventional methods.

Methods: A retrospective study of 30 AIS patients (10 with PTCR, 20 without) from a multicentric European database was conducted. Patients aged ≤ 18 years undergoing surgery for Lenke types 2 or 4 curves with ≥ 2 years of follow-up were included. Radiographic parameters, including Clavicle Angle (CA) and T1 Coronal Tilt (T1CT), were assessed preoperatively, immediately postoperatively, and at 2 years. Demographic, surgical, radiological parameters, and patient-reported outcomes measures (PROMs) were compared between groups.

Results: PTCR significantly improved SI, achieving optimal CA in 80% of cases versus 35% in the non-PTCR group (p = 0.02). CA correction was superior in the PTCR group (-1.66° ± 1.34° vs. 1.06 ± 2.59°, p < 0.001). While T1CT correction showed greater improvement in the PTCR group (-3.62° ± 5.56° vs. -0.31° ± 8.13°) it was not statistically significant (p = 0.258). PTCR did not increase surgical time, blood loss, or complications.

Conclusions: PTCR is a promising approach for managing shoulder imbalance in AIS patients with Lenke types 2 or 4 curves. Larger prospective studies are necessary to validate these findings.

Level of evidence: Level of Evidence: III.

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改善lenke 2型和4型青少年特发性脊柱侧凸的肩关节平衡：胸近端凹棒技术的临床优势。

目的：与传统方法相比，评价一种新型胸近端凹杆（PTCR）技术改善青少年特发性脊柱侧凸（AIS）患者Lenke 2型和4型曲线术后肩部不平衡（SI）的效果。方法：对来自欧洲多中心数据库的30例AIS患者（10例有PTCR， 20例无PTCR）进行回顾性研究。纳入年龄≤18岁的Lenke 2型或4型曲线手术患者，随访≥2年。影像学参数，包括锁骨角（CA）和T1冠状倾斜（T1CT），在术前，术后立即和2年时进行评估。比较两组之间的人口统计学、外科、放射学参数和患者报告的结果测量（PROMs）。结果：PTCR显著改善SI， 80%的病例达到最佳CA，而非PTCR组为35% （p = 0.02）。PTCR组的CA矫正效果更佳（-1.66°±1.34°vs. 1.06±2.59°）。结论：PTCR是治疗Lenke 2型或4型弯AIS患者肩部不平衡的一种有希望的方法。需要更大规模的前瞻性研究来验证这些发现。证据水平：证据水平：III。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Spine deformity

CiteScore

3.20

自引率

18.80%

发文量

167

期刊介绍： Spine Deformity the official journal of the?Scoliosis Research Society is a peer-refereed publication to disseminate knowledge on basic science and clinical research into the?etiology?biomechanics?treatment?methods and outcomes of all types of?spinal deformities. The international members of the Editorial Board provide a worldwide perspective for the journal's area of interest.The?journal?will enhance the mission of the Society which is to foster the optimal care of all patients with?spine?deformities worldwide. Articles published in?Spine Deformity?are Medline indexed in PubMed.? The journal publishes original articles in the form of clinical and basic research. Spine Deformity will only publish studies that have institutional review board (IRB) or similar ethics committee approval for human and animal studies and have strictly observed these guidelines. The minimum follow-up period for follow-up clinical studies is 24 months.