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The changes of the interspace angle after anterior correction and instrumentation in adolescent idiopathic scoliosis patients.

Wang Y, Qiu G, Yu B, Zhang J, Li J, Weng X, Shen J, Fei Q, Li Q - J Orthop Surg Res (2007)

Bottom Line: There was significant correlation between the loss of the interspace angle and the loss of coronal Cobb angle of the main curve during follow-up(r = 0.483, P = 0.007).The interspace angle could be improved after anterior correction and instrumentation surgery, but it became larger during follow-up.The loss of the interspace angle was correlated with the loss of coronal Cobb angle of the main curve during follow-up.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China. ypwang@medmail.com.cn

ABSTRACT

Background: In idiopathic scoliosis patients, after anterior spinal fusion and instrumentation, the discs (interspace angle) between the lowest instrumented vertebra (LIV) and the next caudal vertebra became more wedged. We reviewed these patients and analyzed the changes of the angle.

Methods: By reviewing the medical records and roentgenograms of adolescent idiopathic scoliosis patients underwent anterior spinal fusion and instrumentation, Cobb angle of the curve, correction rate, coronal balance, LIV rotation, interspace angle were measured and analyzed.

Results: There were total 30 patients included. The mean coronal Cobb angle of the main curve (thoracolumbar/lumbar curve) before and after surgery were 48.9 degrees and 11.7 degrees , respectively, with an average correction rate of 76.1%. The average rotation of LIV before surgery was 2.1 degree, and was improved to 1.2 degree after surgery. The interspace angle before surgery, on convex side-bending films, after surgery, at final follow up were 3.2 degrees , -2.3 degrees , 1.8 degrees and 4.9 degrees , respectively. The difference between the interspace angle after surgery and that preoperatively was not significant (P = 0.261), while the interspace angle at final follow-up became larger than that after surgery, and the difference was significant(P = 0.012). The interspace angle after surgery was correlated with that on convex side-bending films (r = 0.418, P = 0.022), and the interspace angle at final follow-up was correlated with that after surgery (r = 0.625, P = 0.000). There was significant correlation between the loss of the interspace angle and the loss of coronal Cobb angle of the main curve during follow-up(r = 0.483, P = 0.007).

Conclusion: The interspace angle could be improved after anterior correction and instrumentation surgery, but it became larger during follow-up. The loss of the interspace angle was correlated with the loss of coronal Cobb angle of the main curve during follow-up.

No MeSH data available.


Related in: MedlinePlus

A 17-year-old female, PUMC Ic type. Preoperative X-ray showed a 52° left lumbar curve with the apex at L1,2 disc(A, B). The interspace angle between L3 and L4 was -5°. On the right Bending film, the interspace angle was 0°(C). On the left Bending film, it was still -5°(D), and T12-L1and L2,3 disc didn't open, so the fusion should include T12 to L3. Postoperative films showed a good correction and the interspace angle improved to 0° (E, F). Nine months later, there were some loss of the correction and the interspace angle increased to 7° (G, H).
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Figure 2: A 17-year-old female, PUMC Ic type. Preoperative X-ray showed a 52° left lumbar curve with the apex at L1,2 disc(A, B). The interspace angle between L3 and L4 was -5°. On the right Bending film, the interspace angle was 0°(C). On the left Bending film, it was still -5°(D), and T12-L1and L2,3 disc didn't open, so the fusion should include T12 to L3. Postoperative films showed a good correction and the interspace angle improved to 0° (E, F). Nine months later, there were some loss of the correction and the interspace angle increased to 7° (G, H).

Mentions: The changes of the interspace angle before and after surgery were list in table 2. The mean interspace angle was 3.2° preoperatively, after surgery, it was corrected to 1.8°, but the difference was not significant (t = 1.146, P = 0.261). The differences of the interspace angle between L2 and L3, L3 and L4 before and after surgery were not significant(t = 1.309, P = 0.321; t = 0.299, P = 0.768), while it's significant for the angle between L4 and L5(t = 3.517, P = 0.017). During follow-up, the interspace angle became larger than that after surgery (Fig. 2), and the difference was significant (t = 2.684, P = 0.012). The coronal Cobb angle of the main curves were also larger than those after surgery, and the differences were also significant (t = 5.58, P = 0.000). The interspace angle after surgery was correlated with that on Bending films (r = 0.418, P = 0.022), and the interspace angle at final follow-up was correlated with that after surgery (r = 0.625, P = 0.000). There was moderate correlation between the loss of the interspace angle and the loss of coronal Cobb angle of the main curve during follow-up(r = 0.483, P = 0.007)(Table 3). There was no significant difference of the interspace angle after surgery, at final follow-up or the loss of interspace angle between the patients with single curve or double curves (2.6° vs. 1.4°, t = 0.452, P = 0.654; 3.2° vs. 5.4°, t = -0.665, P = 0.511; 3.6° vs. 3.2°, t = 0.177, P = 0.860). The interspace angle after surgery, at final follow-up and the loss of interspace angle were all larger in patients with LIV located at one vertebra above the lower end vertebra than those with LIV located at lower end vertebra, and the differences were all significant (Table 4).


The changes of the interspace angle after anterior correction and instrumentation in adolescent idiopathic scoliosis patients.

Wang Y, Qiu G, Yu B, Zhang J, Li J, Weng X, Shen J, Fei Q, Li Q - J Orthop Surg Res (2007)

A 17-year-old female, PUMC Ic type. Preoperative X-ray showed a 52° left lumbar curve with the apex at L1,2 disc(A, B). The interspace angle between L3 and L4 was -5°. On the right Bending film, the interspace angle was 0°(C). On the left Bending film, it was still -5°(D), and T12-L1and L2,3 disc didn't open, so the fusion should include T12 to L3. Postoperative films showed a good correction and the interspace angle improved to 0° (E, F). Nine months later, there were some loss of the correction and the interspace angle increased to 7° (G, H).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2198907&req=5

Figure 2: A 17-year-old female, PUMC Ic type. Preoperative X-ray showed a 52° left lumbar curve with the apex at L1,2 disc(A, B). The interspace angle between L3 and L4 was -5°. On the right Bending film, the interspace angle was 0°(C). On the left Bending film, it was still -5°(D), and T12-L1and L2,3 disc didn't open, so the fusion should include T12 to L3. Postoperative films showed a good correction and the interspace angle improved to 0° (E, F). Nine months later, there were some loss of the correction and the interspace angle increased to 7° (G, H).
Mentions: The changes of the interspace angle before and after surgery were list in table 2. The mean interspace angle was 3.2° preoperatively, after surgery, it was corrected to 1.8°, but the difference was not significant (t = 1.146, P = 0.261). The differences of the interspace angle between L2 and L3, L3 and L4 before and after surgery were not significant(t = 1.309, P = 0.321; t = 0.299, P = 0.768), while it's significant for the angle between L4 and L5(t = 3.517, P = 0.017). During follow-up, the interspace angle became larger than that after surgery (Fig. 2), and the difference was significant (t = 2.684, P = 0.012). The coronal Cobb angle of the main curves were also larger than those after surgery, and the differences were also significant (t = 5.58, P = 0.000). The interspace angle after surgery was correlated with that on Bending films (r = 0.418, P = 0.022), and the interspace angle at final follow-up was correlated with that after surgery (r = 0.625, P = 0.000). There was moderate correlation between the loss of the interspace angle and the loss of coronal Cobb angle of the main curve during follow-up(r = 0.483, P = 0.007)(Table 3). There was no significant difference of the interspace angle after surgery, at final follow-up or the loss of interspace angle between the patients with single curve or double curves (2.6° vs. 1.4°, t = 0.452, P = 0.654; 3.2° vs. 5.4°, t = -0.665, P = 0.511; 3.6° vs. 3.2°, t = 0.177, P = 0.860). The interspace angle after surgery, at final follow-up and the loss of interspace angle were all larger in patients with LIV located at one vertebra above the lower end vertebra than those with LIV located at lower end vertebra, and the differences were all significant (Table 4).

Bottom Line: There was significant correlation between the loss of the interspace angle and the loss of coronal Cobb angle of the main curve during follow-up(r = 0.483, P = 0.007).The interspace angle could be improved after anterior correction and instrumentation surgery, but it became larger during follow-up.The loss of the interspace angle was correlated with the loss of coronal Cobb angle of the main curve during follow-up.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China. ypwang@medmail.com.cn

ABSTRACT

Background: In idiopathic scoliosis patients, after anterior spinal fusion and instrumentation, the discs (interspace angle) between the lowest instrumented vertebra (LIV) and the next caudal vertebra became more wedged. We reviewed these patients and analyzed the changes of the angle.

Methods: By reviewing the medical records and roentgenograms of adolescent idiopathic scoliosis patients underwent anterior spinal fusion and instrumentation, Cobb angle of the curve, correction rate, coronal balance, LIV rotation, interspace angle were measured and analyzed.

Results: There were total 30 patients included. The mean coronal Cobb angle of the main curve (thoracolumbar/lumbar curve) before and after surgery were 48.9 degrees and 11.7 degrees , respectively, with an average correction rate of 76.1%. The average rotation of LIV before surgery was 2.1 degree, and was improved to 1.2 degree after surgery. The interspace angle before surgery, on convex side-bending films, after surgery, at final follow up were 3.2 degrees , -2.3 degrees , 1.8 degrees and 4.9 degrees , respectively. The difference between the interspace angle after surgery and that preoperatively was not significant (P = 0.261), while the interspace angle at final follow-up became larger than that after surgery, and the difference was significant(P = 0.012). The interspace angle after surgery was correlated with that on convex side-bending films (r = 0.418, P = 0.022), and the interspace angle at final follow-up was correlated with that after surgery (r = 0.625, P = 0.000). There was significant correlation between the loss of the interspace angle and the loss of coronal Cobb angle of the main curve during follow-up(r = 0.483, P = 0.007).

Conclusion: The interspace angle could be improved after anterior correction and instrumentation surgery, but it became larger during follow-up. The loss of the interspace angle was correlated with the loss of coronal Cobb angle of the main curve during follow-up.

No MeSH data available.


Related in: MedlinePlus