Lenke-1青少年特发性脊柱侧弯选择性胸部融合术后融合术质量转移与术后远端增加的关系。

IF 2.3 Q2 ORTHOPEDICS
Asian Spine Journal Pub Date : 2023-12-01 Epub Date: 2023-11-10 DOI:10.31616/asj.2022.0466
Yang Li, Jianlong Li, Keith D K Luk, Chenggui Zhang, Jianmin Sun, Guodong Wang
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引用次数: 0

摘要

研究设计:这是一项回顾性队列研究。目的:本研究旨在探讨Lenke-1青少年特发性脊柱侧弯(AIS)术后远端加曲的危险因素,并验证融合质量移位(FMS)与术后远端附加的关系。文献综述:术后远端曲线加曲是AIS的并发症之一。FMS已被提出用于防止术后远端加钉,这需要不同机构的进一步验证。方法:本研究包括60例接受选择性胸廓融合术的Lenke1型AIS患者。术前、术后和最后随访时对冠状骨-脊柱对齐参数进行分析。术后FMS分为两组:平衡组(FMS≤20mm)和不平衡组(FMS>20mm)。独立t检验用于比较各组之间的定量数据,卡方检验用于定性数据。此外,还采用二元逻辑回归和受试者操作特征曲线分析来确定AIS术后远端附加的危险因素。结果:在2年的随访中,不平衡组(24例患者中有17例)比平衡组(36例患者中的6例)更有可能出现增重;结论:术中达到平衡的融合质量对于避免术后远端增重很重要,FMS为
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Relationship between Fusion Mass Shift and Postoperative Distal Adding-on in Lenke 1 Adolescent Idiopathic Scoliosis after Selective Thoracic Fusion.

Study design: This is a retrospective cohort study.

Purpose: This study aims to investigate the risk factors for postoperative distal adding-on in Lenke 1 adolescent idiopathic scoliosis (AIS) and validate the relationship between fusion mass shift (FMS) and postoperative distal adding-on.

Overview of literature: Postoperative distal curve adding-on is one of the complications in AIS. FMS has been proposed to prevent postoperative distal adding-on, which requires further validation from different institutions.

Methods: This study included 60 patients with Lenke 1 AIS who underwent selective thoracic fusion surgery. Coronal spinal alignment parameters were analyzed preoperatively, postoperatively, and at the final follow-up. The postoperative FMS was divided into two groups: the balanced group (FMS ≤20 mm) and the unbalanced group (FMS >20 mm). An independent t-test was used to compare quantitative data between groups, and a chi-square test was used for qualitative data. Furthermore, binary logistic regression and receiver operating characteristics curve analyses were used to identify the risk factors for postoperative distal adding-on in AIS.

Results: At 2-year follow-up, the unbalanced group was more likely to have adding-on (17 of 24 patients) than the balanced group (six of 36 patients; p<0.001). Twenty-three patients with distal adding-on had significantly greater preoperative and postoperative lower instrumented vertebrae (LIV) rotation, FMS, and FMS angle (FMSA) than those without postoperative distal adding-on. Binary logistic regression analysis selected three independent risk factors for adding-on incidence after surgery: FMS (odds ratio [OR], 1.115; 95% confidence interval [CI], 1.049-1.185; p<0.001), FMSA (OR, 1.590; 95% CI, 1.225-2.064; p<0.001), and postoperative LIV rotation (OR, 6.581; 95% CI, 2.280-19.000; p<0.001).

Conclusions: Achieving a balanced fusion mass intraoperatively is important to avoid postoperative distal adding-on, with FMS of <20 mm and FMS angle of <4.5°. Furthermore, correcting LIV rotation helps to decrease the incidence of postoperative distal addingon.

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来源期刊
Asian Spine Journal
Asian Spine Journal ORTHOPEDICS-
CiteScore
5.10
自引率
4.30%
发文量
108
审稿时长
24 weeks
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