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Anterior versus posterior approach in Lenke 5C adolescent idiopathic scoliosis: a meta-analysis of fusion segments and radiological outcomes.

Luo M, Wang W, Shen M, Xia L - J Orthop Surg Res (2016)

Bottom Line: Radiological outcomes between anterior and posterior approach in Lenke 5C curves were still controversial.RevMan 5.3 was adopted for data analysis.The article type of this study is meta-analysis and prospective registration is not required.

View Article: PubMed Central - PubMed

Affiliation: Institute of Spinal Deformity, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450000, People's Republic of China.

ABSTRACT

Background: Radiological outcomes between anterior and posterior approach in Lenke 5C curves were still controversial. Meta-analysis on published articles to compare fusion segments and radiological outcomes between the two surgical approaches was performed.

Methods: Electronic database was conducted for searching studies concerning the anterior versus posterior approach in Lenke 5C curves. After quality assessment, data of means, standard deviations, and sample sizes were extracted. RevMan 5.3 was adopted for data analysis.

Results: Seven case-control studies involving 308 Lenke 5C AIS patients were identified in the meta-analysis. No significant differences were noted in correction rate of thoracolumbar/lumbar curve (95 % CI -6.02 to 4.32, P = 0.75) and incidence of proximal junctional kyphosis (95 % CI 0.12 to 7.19, P = 0.94) of final follow-up, in change values of thoracolumbar/lumbar curve (95 % CI -3.28 to 7.19, P = 0.46) and thoracic kyphosis (95 % CI -4.10 to 0.13, P = 0.07). The anterior approach represented a significant shorter fusion segments compared to posterior approach (95 % CI -1.72 to -0.71, P < 0.00001). The posterior approach obtained a larger increasing Cobb angle of lumbar lordosis than the anterior approach (95 % CI -6.06 to -0.61, P = 0.02).

Conclusions: The anterior and posterior approach can obtain comparable coronal correction, change values of thoracic kyphosis, and incidence of proximal junctional kyphosis. The anterior approach saves approximate one more fusion segment, and the posterior approach can obtain a larger increasing Cobb angle of lumbar lordosis, from preoperation to final follow-up.

Trial registration: The article type of this study is meta-analysis and prospective registration is not required.

No MeSH data available.


Related in: MedlinePlus

Flow diagram of study selection
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Related In: Results  -  Collection

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Fig1: Flow diagram of study selection

Mentions: Meta-analysis was performed on outcomes of seven case-control studies [21–27], two articles were excluded for parallel publication [28, 29]. The details of the study selection were shown in Fig. 1. All of the seven studies, 308 patients diagnosed with Lenke 5C AIS were included, and no significant differences were observed in age and preoperative TL/L Cobb angle between the anterior and posterior approach. The description information about the included articles was shown in Table 1.Fig. 1


Anterior versus posterior approach in Lenke 5C adolescent idiopathic scoliosis: a meta-analysis of fusion segments and radiological outcomes.

Luo M, Wang W, Shen M, Xia L - J Orthop Surg Res (2016)

Flow diagram of study selection
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4940871&req=5

Fig1: Flow diagram of study selection
Mentions: Meta-analysis was performed on outcomes of seven case-control studies [21–27], two articles were excluded for parallel publication [28, 29]. The details of the study selection were shown in Fig. 1. All of the seven studies, 308 patients diagnosed with Lenke 5C AIS were included, and no significant differences were observed in age and preoperative TL/L Cobb angle between the anterior and posterior approach. The description information about the included articles was shown in Table 1.Fig. 1

Bottom Line: Radiological outcomes between anterior and posterior approach in Lenke 5C curves were still controversial.RevMan 5.3 was adopted for data analysis.The article type of this study is meta-analysis and prospective registration is not required.

View Article: PubMed Central - PubMed

Affiliation: Institute of Spinal Deformity, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450000, People's Republic of China.

ABSTRACT

Background: Radiological outcomes between anterior and posterior approach in Lenke 5C curves were still controversial. Meta-analysis on published articles to compare fusion segments and radiological outcomes between the two surgical approaches was performed.

Methods: Electronic database was conducted for searching studies concerning the anterior versus posterior approach in Lenke 5C curves. After quality assessment, data of means, standard deviations, and sample sizes were extracted. RevMan 5.3 was adopted for data analysis.

Results: Seven case-control studies involving 308 Lenke 5C AIS patients were identified in the meta-analysis. No significant differences were noted in correction rate of thoracolumbar/lumbar curve (95 % CI -6.02 to 4.32, P = 0.75) and incidence of proximal junctional kyphosis (95 % CI 0.12 to 7.19, P = 0.94) of final follow-up, in change values of thoracolumbar/lumbar curve (95 % CI -3.28 to 7.19, P = 0.46) and thoracic kyphosis (95 % CI -4.10 to 0.13, P = 0.07). The anterior approach represented a significant shorter fusion segments compared to posterior approach (95 % CI -1.72 to -0.71, P < 0.00001). The posterior approach obtained a larger increasing Cobb angle of lumbar lordosis than the anterior approach (95 % CI -6.06 to -0.61, P = 0.02).

Conclusions: The anterior and posterior approach can obtain comparable coronal correction, change values of thoracic kyphosis, and incidence of proximal junctional kyphosis. The anterior approach saves approximate one more fusion segment, and the posterior approach can obtain a larger increasing Cobb angle of lumbar lordosis, from preoperation to final follow-up.

Trial registration: The article type of this study is meta-analysis and prospective registration is not required.

No MeSH data available.


Related in: MedlinePlus