Presence of compensatory curve predicts postoperative curve progression in congenital scoliosis after thoracolumbar hemivertebra resection and short fusion.

IF 2.6 3区 医学 Q2 CLINICAL NEUROLOGY European Spine Journal Pub Date : 2024-12-01 Epub Date: 2024-07-15 DOI:10.1007/s00586-024-08398-0
Yanjie Xu, Jie Li, Dongyue Li, Peiyu Li, Abdukahar Kiram, Hui Xu, Zhen Jin, Ziyang Tang, Zongshan Hu, Yong Qiu, Zhen Liu, Zezhang Zhu
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Abstract

Purpose: To investigate the impact of preoperative compensatory curve on the postoperative curve progression in congenital scoliosis (CS) patients following thoracolumbar hemivertebra (HV) resection and short fusion.

Methods: This study retrospectively reviewed a consecutive cohort of patients with CS who underwent thoracolumbar HV resection and short fusion with a minimum of 2 years follow-up. According to the preoperative curve pattern, patients were divided into compensatory curve group non-compensatory curve group. Based on the postoperative coronal curve evolution, patients were further divided into the progressed group (Group P, with curve decompensation ≥ 20°) and the non-progressed group (Group NP, characterized by well-compensated curves).

Results: A total of 127 patients were included in this study, with 31 patients in the compensatory curve group and 96 patients in the non-compensatory curve group. The incidence of postoperative coronal curve progression was significantly higher in the compensatory curve group than that in non-compensatory curve group (35.5% vs. 13.5%, p = 0.007). In the compensatory curve group, patients who experienced postoperative curve progression showed fewer fusion segments (p = 0.001), greater preoperative UIV translation (p = 0.006), greater preoperative LIV tilt (p = 0.017), and larger postoperative UIV tilt (p < 0.001) compared with patients in group NP. Multiple logistic regression demonstrated that the shorter fusion segments and greater postoperative UIV tilt were two independent risk factors for postoperative curve progression.

Conclusion: The presence of the compensatory curve was associated with a higher incidence of postoperative curve progression in patients with CS who underwent thoracolumbar HV resection and short fusion. Shorter fusion segments and greater postoperative UIV tilt were found to be the risk factors for postoperative curve progression.

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胸腰椎半椎体切除术和短融合术后先天性脊柱侧凸的代偿性曲线预示着术后曲线的发展。
目的:研究先天性脊柱侧凸(CS)患者在接受胸腰椎半椎体(HV)切除术和短融合术后,术前代偿曲线对术后曲线发展的影响:本研究回顾性分析了一批连续接受胸腰椎半椎体(HV)切除术和短椎融合术的先天性脊柱侧凸(CS)患者,随访时间至少2年。根据术前的曲线模式,患者被分为代偿曲线组和非代偿曲线组。根据术后冠状曲线演变情况,患者又被分为进展组(P组,曲线失代偿≥20°)和非进展组(NP组,曲线代偿良好):本研究共纳入 127 例患者,其中代偿性曲线组 31 例,非代偿性曲线组 96 例。代偿性曲线组术后冠状曲线恶化的发生率明显高于非代偿性曲线组(35.5% 对 13.5%,P = 0.007)。在代偿性曲线组中,术后出现曲线进展的患者的融合节段较少(p = 0.001),术前 UIV 平移较大(p = 0.006),术前 LIV 倾斜较大(p = 0.017),术后 UIV 倾斜较大(p 结论:代偿性曲线组的患者术后出现曲线进展的比例明显高于非代偿性曲线组(35.5% vs. 13.5%,p = 0.007):在接受胸腰椎 HV 切除术和短融合术的 CS 患者中,代偿性曲线的存在与较高的术后曲线进展发生率有关。较短的融合节段和较大的术后 UIV 倾斜是导致术后曲线恶化的危险因素。
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来源期刊
European Spine Journal
European Spine Journal 医学-临床神经学
CiteScore
4.80
自引率
10.70%
发文量
373
审稿时长
2-4 weeks
期刊介绍: "European Spine Journal" is a publication founded in response to the increasing trend toward specialization in spinal surgery and spinal pathology in general. The Journal is devoted to all spine related disciplines, including functional and surgical anatomy of the spine, biomechanics and pathophysiology, diagnostic procedures, and neurology, surgery and outcomes. The aim of "European Spine Journal" is to support the further development of highly innovative spine treatments including but not restricted to surgery and to provide an integrated and balanced view of diagnostic, research and treatment procedures as well as outcomes that will enhance effective collaboration among specialists worldwide. The “European Spine Journal” also participates in education by means of videos, interactive meetings and the endorsement of educative efforts. Official publication of EUROSPINE, The Spine Society of Europe
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