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Video-assisted thoracoscopic surgery for correction of adolescent idiopatic scoliosis: comparison of 4.5 mm versus 5.5 mm rod constructs.

Kim HS, Park JO, Nanda A, Kho PA, Kim JY, Lee HM, Moon SH, Ha JW, Ahn EK, Shin DE, Kim SJ, Moon ES - Yonsei Med. J. (2010)

Bottom Line: The purpose of this study is to report the comparative results of thoracoscopic correction achieved via cantilever technique using a 4.5 mm thin rod and the poly-axial reduction screw technique using a 5.5 mm thick rod in Lenke type 1 adolescent idiopathic scoliosis (AIS).There were no significant differences between the two groups in terms of kyphosis, coronal balance, or tilt angle at the time of the final follow-up.The mean number of levels fused was 6.2 in the thin rod group, compared with 5.9 levels in the thick rod group.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: The purpose of this study is to report the comparative results of thoracoscopic correction achieved via cantilever technique using a 4.5 mm thin rod and the poly-axial reduction screw technique using a 5.5 mm thick rod in Lenke type 1 adolescent idiopathic scoliosis (AIS).

Materials and methods: Radiographic data, Scoliosis Research Society (SRS) patient-based outcome questionnaires, and operative records were reviewed for forty-nine patients undergoing surgical treatment of scoliosis. The study group was divided into a 4.5 mm thin rod group (n = 24) and a 5.5 mm thick rod group (n = 25). The radiographic parameters that were analyzed included coronal curve correction, the most caudal instrumented vertebra tilt angle correction, coronal balance, and thoracic kyphosis.

Results: The major curve was corrected from 49.8 degrees and 47.2 degrees pre-operatively to 24.5 degrees and 18.8 degrees at the final follow-up for the thin and thick rod groups, respectively (50.8% vs. 60.2% correction). There were no significant differences between the two groups in terms of kyphosis, coronal balance, or tilt angle at the time of the final follow-up. The mean number of levels fused was 6.2 in the thin rod group, compared with 5.9 levels in the thick rod group. There were no major intraoperative complications in either group.

Conclusion: Significant correction loss was observed in the thin rod system at the final follow-up though both groups had comparable correction immediately post-operative. Therefore, the thick rod with poly axial screw system helps to maintain post-operative correction.

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Related in: MedlinePlus

Radiographs of the spine in a patient instrumented with thick 5.5 mm diameter rod. (A) Pre-operative anteroposterior radiograph. (B) Immediate post-operative anteroposterior supine radiograph. (C) The anteroposterior standing radiograph made thirty-eight months after surgery, showing no loss of correction compared to immediate post-operative radiograph.
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Figure 2: Radiographs of the spine in a patient instrumented with thick 5.5 mm diameter rod. (A) Pre-operative anteroposterior radiograph. (B) Immediate post-operative anteroposterior supine radiograph. (C) The anteroposterior standing radiograph made thirty-eight months after surgery, showing no loss of correction compared to immediate post-operative radiograph.

Mentions: In the thin rod group, the major curve was corrected from 49.8° pre-operatively to 15.8° (68.3% correction) at the immediate post-operative supine position, 23.2° (53.4% correction) at post-operative 2 weeks in the standing position, and 24.5° (50.8% correction) at the time of the last follow-up. In the thick rod group, the major curve was corrected from 47.2° pre-operatively to 14.1° (70.1% correction) at the immediate post-operative supine position, 18.8° (60.2% correction ratio) at post-operative 2 weeks in the standing position, and 18.7° (60.4% correction) at the time of the last follow-up. It was observed that although there was no significant difference in coronal curve correction between the two groups in the immediate post-operative supine radiographs (p = 0.43), there was a significant difference in the correction at post-operative 2 weeks in the standing position (p = 0.04) as well as at the time of last follow-up (p = 0.01) (Table 2) (Figs. 1 and 2).


Video-assisted thoracoscopic surgery for correction of adolescent idiopatic scoliosis: comparison of 4.5 mm versus 5.5 mm rod constructs.

Kim HS, Park JO, Nanda A, Kho PA, Kim JY, Lee HM, Moon SH, Ha JW, Ahn EK, Shin DE, Kim SJ, Moon ES - Yonsei Med. J. (2010)

Radiographs of the spine in a patient instrumented with thick 5.5 mm diameter rod. (A) Pre-operative anteroposterior radiograph. (B) Immediate post-operative anteroposterior supine radiograph. (C) The anteroposterior standing radiograph made thirty-eight months after surgery, showing no loss of correction compared to immediate post-operative radiograph.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2908885&req=5

Figure 2: Radiographs of the spine in a patient instrumented with thick 5.5 mm diameter rod. (A) Pre-operative anteroposterior radiograph. (B) Immediate post-operative anteroposterior supine radiograph. (C) The anteroposterior standing radiograph made thirty-eight months after surgery, showing no loss of correction compared to immediate post-operative radiograph.
Mentions: In the thin rod group, the major curve was corrected from 49.8° pre-operatively to 15.8° (68.3% correction) at the immediate post-operative supine position, 23.2° (53.4% correction) at post-operative 2 weeks in the standing position, and 24.5° (50.8% correction) at the time of the last follow-up. In the thick rod group, the major curve was corrected from 47.2° pre-operatively to 14.1° (70.1% correction) at the immediate post-operative supine position, 18.8° (60.2% correction ratio) at post-operative 2 weeks in the standing position, and 18.7° (60.4% correction) at the time of the last follow-up. It was observed that although there was no significant difference in coronal curve correction between the two groups in the immediate post-operative supine radiographs (p = 0.43), there was a significant difference in the correction at post-operative 2 weeks in the standing position (p = 0.04) as well as at the time of last follow-up (p = 0.01) (Table 2) (Figs. 1 and 2).

Bottom Line: The purpose of this study is to report the comparative results of thoracoscopic correction achieved via cantilever technique using a 4.5 mm thin rod and the poly-axial reduction screw technique using a 5.5 mm thick rod in Lenke type 1 adolescent idiopathic scoliosis (AIS).There were no significant differences between the two groups in terms of kyphosis, coronal balance, or tilt angle at the time of the final follow-up.The mean number of levels fused was 6.2 in the thin rod group, compared with 5.9 levels in the thick rod group.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: The purpose of this study is to report the comparative results of thoracoscopic correction achieved via cantilever technique using a 4.5 mm thin rod and the poly-axial reduction screw technique using a 5.5 mm thick rod in Lenke type 1 adolescent idiopathic scoliosis (AIS).

Materials and methods: Radiographic data, Scoliosis Research Society (SRS) patient-based outcome questionnaires, and operative records were reviewed for forty-nine patients undergoing surgical treatment of scoliosis. The study group was divided into a 4.5 mm thin rod group (n = 24) and a 5.5 mm thick rod group (n = 25). The radiographic parameters that were analyzed included coronal curve correction, the most caudal instrumented vertebra tilt angle correction, coronal balance, and thoracic kyphosis.

Results: The major curve was corrected from 49.8 degrees and 47.2 degrees pre-operatively to 24.5 degrees and 18.8 degrees at the final follow-up for the thin and thick rod groups, respectively (50.8% vs. 60.2% correction). There were no significant differences between the two groups in terms of kyphosis, coronal balance, or tilt angle at the time of the final follow-up. The mean number of levels fused was 6.2 in the thin rod group, compared with 5.9 levels in the thick rod group. There were no major intraoperative complications in either group.

Conclusion: Significant correction loss was observed in the thin rod system at the final follow-up though both groups had comparable correction immediately post-operative. Therefore, the thick rod with poly axial screw system helps to maintain post-operative correction.

Show MeSH
Related in: MedlinePlus