Is the anterior approach still superior to posterior correction in AIS regarding correction, fusion levels and kyphosis when modern posterior systems are used?
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| Titel: | Is the anterior approach still superior to posterior correction in AIS regarding correction, fusion levels and kyphosis when modern posterior systems are used? |
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| Autoren: | Ahmed Hammad, Johanna Eberl, André Wirries, Florian Geiger |
| Quelle: | Spine Deform |
| Verlagsinformationen: | Springer Science and Business Media LLC, 2024. |
| Publikationsjahr: | 2024 |
| Schlagwörter: | Male, Lumbar Vertebrae, Adolescent, Fusion levels, Thoracic Vertebrae/surgery [MeSH], Case Series, Male [MeSH], Kyphosis/surgery [MeSH], AIS, Pedicle Screws [MeSH], Spinal Fusion/methods [MeSH], Scoliosis/surgery [MeSH], Adolescent [MeSH], Female [MeSH], Lordosis/diagnostic imaging [MeSH], Humans [MeSH], Treatment Outcome [MeSH], Retrospective Studies [MeSH], Correction, Scoliosis/diagnostic imaging [MeSH], Lordosis/surgery [MeSH], Posterior, Thoracic Vertebrae/diagnostic imaging [MeSH], Anterior, Spinal Fusion/instrumentation [MeSH], Lumbar Vertebrae/surgery [MeSH], Kyphosis/diagnostic imaging [MeSH], Scoliosis, Thoracic Vertebrae, 03 medical and health sciences, Spinal Fusion, Treatment Outcome, 0302 clinical medicine, Pedicle Screws, Lordosis, Humans, Female, Kyphosis, Retrospective Studies |
| Beschreibung: | Purpose The aim of our study is to compare anterior and posterior corrections of thoracic (Lenke I) and lumbar (Lenke V) curves when modern posterior pedicle screw systems with vertebral derotation techniques are used. Curves that could not be corrected with both systems were excluded. Methods A thoracic group (N = 56) of Lenke I AIS patients (18 anterior and 38 posterior) and a lumbar group (N = 42) of Lenke V patients (14 anterior and 28 posterior) with similar curves Results Thoracic group The mean postoperative correction (POC) was 68 ± 13.4% in the anterior and 72 ± 10.5% in the posterior group. The postoperative change in thoracic kyphosis was +4° and +5° respectively. The median length of fusion was eight segments in the posterior and seven segments in the anterior groups. In 89% the LIV was EV or shorter in the anterior, and in 71% of the posterior corrections. Lumbar group The mean POC was 75 ± 18.3% (anterior) and 72 ± 8.5% (posterior). The postoperative gain in lumbar lordosis was 0.8° (anterior) and 4° (posterior). The median length of fusion was five segments in both groups and there was no difference in relation of the LIV to the EV. Conclusion With modern implants and derotation techniques, the posterior approach can achieve similar coronal correction, apical derotation and thoracic kyphosis with similar length of fusion and better lumbar lordosis restoration. |
| Publikationsart: | Article Other literature type |
| Sprache: | English |
| ISSN: | 2212-1358 2212-134X |
| DOI: | 10.1007/s43390-024-00832-z |
| Zugangs-URL: | https://pubmed.ncbi.nlm.nih.gov/38468120 https://repository.publisso.de/resource/frl:6492426 |
| Rights: | CC BY |
| Dokumentencode: | edsair.doi.dedup.....95a51d4caa051fa9b0c2c2fa2d17b91f |
| Datenbank: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstract: | Purpose The aim of our study is to compare anterior and posterior corrections of thoracic (Lenke I) and lumbar (Lenke V) curves when modern posterior pedicle screw systems with vertebral derotation techniques are used. Curves that could not be corrected with both systems were excluded. Methods A thoracic group (N = 56) of Lenke I AIS patients (18 anterior and 38 posterior) and a lumbar group (N = 42) of Lenke V patients (14 anterior and 28 posterior) with similar curves Results Thoracic group The mean postoperative correction (POC) was 68 ± 13.4% in the anterior and 72 ± 10.5% in the posterior group. The postoperative change in thoracic kyphosis was +4° and +5° respectively. The median length of fusion was eight segments in the posterior and seven segments in the anterior groups. In 89% the LIV was EV or shorter in the anterior, and in 71% of the posterior corrections. Lumbar group The mean POC was 75 ± 18.3% (anterior) and 72 ± 8.5% (posterior). The postoperative gain in lumbar lordosis was 0.8° (anterior) and 4° (posterior). The median length of fusion was five segments in both groups and there was no difference in relation of the LIV to the EV. Conclusion With modern implants and derotation techniques, the posterior approach can achieve similar coronal correction, apical derotation and thoracic kyphosis with similar length of fusion and better lumbar lordosis restoration. |
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| ISSN: | 22121358 2212134X |
| DOI: | 10.1007/s43390-024-00832-z |