Linden Gabriel S, Adhiyaman Akshitha, Zucker Colson P, Thakur Ankush, Wisch Jenna L, Hillstrom Howard, Groisser Benjamin N, Mintz Douglas N, Cunningham Matthew E, Haddas Ram, Hresko M Timothy, Blanco John S, Widmann Roger F, Heyer Jessica H
Hospital for Special Surgery, New York, NY.
University of Rochester Medical Center, Rochester, NY.
Spine (Phila Pa 1976). 2024 May 6. doi: 10.1097/BRS.0000000000005021.
Retrospective case series.
To characterize the change in angle of trunk rotation (ATR), axial vertebral rotation (AVR), and body surface rotation (BSR) in patients with adolescent idiopathic scoliosis (AIS) undergoing posterior spinal fusion (PSF) with en-bloc derotation across multiple postoperative visits.
Previous research has documented ATR, AVR, and BSR correction for AIS patients after surgery. However, there is a lack of evidence on the sustainability of this correction over time.
This was a retrospective study from a single-center prospective surface topographic registry of patients with AIS, age 11-20 at time of surgery, who underwent PSF with en-bloc derotation. Patients with previous spine surgery were excluded. ATR was measured with a scoliometer, AVR through EOS radiographic imaging, and BSR via surface topographic scanning, Data collection occurred at: preoperative, six-week, three-month, six-month, one-year, and two-year postoperative visits. BSR and AVR were tracked at the preoperative apical vertebral level, and the level with maximum deformity, at each respective timepoint. Generalized estimating equations models were used for statistical analysis. Covariates included age, sex, and body mass index.
49 patients (73.4% female, mean age 14.6±2.2 years, mean preoperative coronal curve angle 57.9°±8.5, and 67% major thoracic) were evaluated. ATR correction was significantly improved at all postoperative timepoints and there was no significant loss of correction. AVR Max and AVR Apex were significantly improved at all timepoints but there was a significant loss of correction for AVR Apex between the six-week and one-year visit (P=0.032). BSR Max achieved significant improvement at the three-month visit. BSR Apex was significantly improved at the three-month and one-year visit.
ATR and AVR demonstrated significant axial plane correction at two-years postoperative in patients undergoing PSF for AIS. BSR did not maintain significant improvement by the two-year visit.
回顾性病例系列研究。
描述接受后路脊柱融合术（PSF）并进行整块去旋转术的青少年特发性脊柱侧凸（AIS）患者在多次术后随访中躯干旋转角度（ATR）、椎体轴向旋转（AVR）和体表旋转（BSR）的变化情况。
先前的研究记录了AIS患者术后的ATR、AVR和BSR矫正情况。然而，缺乏关于这种矫正随时间可持续性的证据。
这是一项来自单中心前瞻性表面地形学登记处的回顾性研究，研究对象为手术时年龄在11 - 20岁、接受PSF并进行整块去旋转术的AIS患者。排除既往有脊柱手术史的患者。使用脊柱侧凸测量仪测量ATR，通过EOS放射成像测量AVR，通过表面地形扫描测量BSR。数据收集时间点为：术前、术后六周、三个月、六个月、一年和两年。在术前顶椎水平以及每个相应时间点的最大畸形水平追踪BSR和AVR。采用广义估计方程模型进行统计分析。协变量包括年龄、性别和体重指数。
共评估了49例患者（女性占73.4%，平均年龄14.6±2.2岁，术前冠状面平均曲线角度57.9°±8.5，67%为主要胸弯）。术后所有时间点的ATR矫正均有显著改善，且矫正无显著丢失。所有时间点的AVR最大值（AVR Max）和AVR顶椎值（AVR Apex）均有显著改善，但在术后六周和一年的随访之间，AVR Apex的矫正有显著丢失（P = 0.032）。BSR最大值（BSR Max）在术后三个月随访时显著改善。BSR顶椎值（BSR Apex）在术后三个月和一年随访时显著改善。
接受PSF治疗的AIS患者术后两年，ATR和AVR在矢状面显示出显著矫正。到术后两年随访时，BSR未保持显著改善。
