Posteromedial Translation for Correction of Severe Hypokyphosis in Adolescent Idiopathic Scoliosis: Outcome Analysis with 2-year Follow-ups

IF 0.4 Q4 NEUROSCIENCES

Archives of Neuroscience Pub Date : 2023-06-14 DOI:10.5812/ans-133139

B. Mirzashahi, Mohammad Javad Dehghani Firoozabadi, M. Rostami, S. Panahi, Parham Talebiyan, Furqan Mohammed Yaseen Khan

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Abstract

Background: The deformity in the coronal plane is over-emphasized in the surgical management of adolescent idiopathic scoliosis (AIS), whereas the importance of the patient’s sagittal profile is generally neglected. Gold standard treatment in AIS consists of posterior instrumentation, deformity correction - through a reduction maneuver - and arthrodesis. The main focus in most reduction techniques is placed on the correction of deformity in the coronal and/or axial plane, worsening the patient’s sagittal profile. Objectives: This outcome analysis study aimed to investigate the surgical treatment of AIS patients with severe thoracic hypokyphosis (< 10) by adopting the posteromedial translation technique (PMT). Methods: In this retrospective study, the data and records of the patients with minimum 2-year follow-ups were analyzed. Correction of the deformity was radiologically assessed based on Cobb’s angle, thoracic kyphosis, and apex translation. The Scoliosis Research Society 22-item questionnaire (SRS-22r) was used for clinical evaluation before and after the surgery. Results: A total of 11 AIS patients (8 females and 3 males) with hypokyphosis underwent operations by the PMT at Imam Khomeini Hospital Complex between 2000 and 2020. According to the results, 78% correction in the coronal plane and an average correction of 56° (P < 0.001) were obtained. As for the sagittal plane, 18.8° correction was recorded (75%) (P < 0.001). Scoliosis Research Society 22-item questionnaire subscale analysis showed a significant improvement in patients' self-image (P = 0.035) and satisfaction (P = 0.043). Conclusions: The management of hypokyphosis in AIS was challenging. The PMT facilitated the tri-planar deformity correction, including a restoration of the thoracic kyphosis in all patients. A significant improvement was observed in both the coronal and sagittal profiles of the patients.

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后内侧平移矫正青少年特发性脊柱侧凸严重后凸:2年随访的结果分析

背景:在青少年特发性脊柱侧凸(AIS)的手术治疗中，冠状面畸形被过分强调，而患者矢状面轮廓的重要性通常被忽视。AIS的金标准治疗包括后路内固定、畸形矫正(通过复位手法)和关节融合术。大多数复位技术的重点是矫正冠状面和/或轴状面畸形，使患者矢状面轮廓恶化。目的:本结局分析研究旨在探讨采用后内侧平移技术(PMT)手术治疗AIS合并严重胸后凸(< 10)患者。方法:回顾性分析患者至少2年的随访资料和记录。根据Cobb角、胸椎后凸和椎尖移位对畸形的矫正进行放射学评估。采用脊柱侧凸研究学会22题问卷(SRS-22r)进行手术前后临床评价。结果:2000 - 2020年间，伊玛目霍梅尼综合医院共有11例AIS后凸畸形患者(女8例，男3例)接受了PMT手术。结果显示，冠状面矫正率为78%，平均矫正率为56°(P < 0.001)。矢状面矫正率为18.8°(75%)(P < 0.001)。脊柱侧凸学会22项问卷亚量表分析显示，患者自我形象(P = 0.035)和满意度(P = 0.043)均有显著改善。结论:AIS患者后凸畸形的治疗具有挑战性。PMT促进了三平面畸形的矫正，包括所有患者的胸后凸的恢复。患者的冠状面和矢状面均有显著改善。

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Archives of Neuroscience NEUROSCIENCES-

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期刊介绍： Archives of neuroscience is a clinical and basic journal which is informative to all practitioners like Neurosurgeons, Neurologists, Psychiatrists, Neuroscientists. It is the official journal of Brain and Spinal Injury Research Center. The Major theme of this journal is to follow the path of scientific collaboration, spontaneity, and goodwill for the future, by providing up-to-date knowledge for the readers. The journal aims at covering different fields, as the name implies, ranging from research in basic and clinical sciences to core topics such as patient care, education, procuring and correct utilization of resources and bringing to limelight the cherished goals of the institute in providing a standard care for the physically disabled patients. This quarterly journal offers a venue for our researchers and scientists to vent their innovative and constructive research works. The scope of the journal is as far wide as the universe as being declared by the name of the journal, but our aim is to pursue our sacred goals in providing a panacea for the intractable ailments, which leave a psychological element in the daily life of such patients. This authoritative clinical and basic journal was founded by Professor Madjid Samii in 2012.