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논문 기본 정보

자료유형
학술저널
저자정보
Shingo Kuroya (St. Marianna University School of Medicine) Tsutomu Akazawa (St. Marianna University School of Medicine) Toshiaki Kotani (Seirei Sakura Citizen Hospital) Tsuyoshi Sakuma (Seirei Sakura Citizen Hospital) Shohei Minami (Seirei Sakura Citizen Hospital) Yoshiaki Torii (St. Marianna University School of Medicine) Tasuku Umehara (St. Marianna University School of Medicine) Masahiro Iinuma (St. Marianna University School of Medicine) Kenichi Murakami (St. Marianna University School of Medicine) Sumihisa Orita (Chiba University) Kazuhide Inage (Chiba University) Yawara Eguchi (Chiba University) Kazuki Fujimoto (Chiba University) Yasuhiro Shiga (Chiba University) Junichi Nakamura (Chiba University) Gen Inoue (Kitasato University School of Medicine) Masayuki Miyagi (Kitasato University School of Medicine) Wataru Saito1 (Kitasato University School of Medicine) Seiji Ohtori (Chiba University) Hisateru Niki (St. Marianna University School of Medicine)
저널정보
대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.13 No.5
발행연도
2019.1
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793 - 800 (8page)

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Study Design: A retrospective cohort study. Purpose: This study aims to investigate postoperative shoulder imbalance (PSI) ≥5 years postoperatively in patients who underwent posterior spinal fusion using hooks at the upper instrumented vertebra (UIV) for Lenke type 1 adolescent idiopathic scoliosis (AIS). Overview of Literature: Studies have reported PSI due to excessive correction of the main thoracic curve. Methods: We examined 56 patients with AIS who underwent a posterior spinal fusion with hooks at the UIV from 2004 to 2010. Of these, we enrolled 14 patients who underwent surgery, at least, 5 years ago. X-rays and Scoliosis Research Society-22 (SRS-22) questionnaire were administered. To evaluate the shoulder balance, T1 vertebral tilt angle (T1 tilt), clavicle angle, and radiographic shoulder height (RSH) were measured. PSI was considered as the absolute value of the postoperative RSH being ≥20 mm. Based on radiographs obtained immediately postoperatively, we divided patients into two groups as follows: the balanced group (absolute value of RSH <20 mm) and imbalanced group (absolute value of RSH ≥20 mm). Results: The frequency of PSI was 28.6% immediately postoperatively, 0% 2 years postoperatively, and 7.1% at the last follow-up. In the balanced group, PSI did not occur even at 2 years postoperatively or at the last follow-up. In the imbalanced group, PSI was improved in all patients 2 years postoperatively and all patients, except one patient, at the last follow-up. No significant differences were noted in the frequency of distal adding-on at 2 years postoperatively or the last follow-up between the balanced group and the imbalanced group. We observed moderate negative correlations between the absolute value of T1 tilt and the SRS-22 pain and satisfaction at the last follow-up. Conclusions: Hooks at the UIV could adjust the shoulder balance to avoid long-term PSI in patients with AIS.
#Adolescent idiopathic scoliosis #Long-term follow-up #Postoperative shoulder imbalance #Shoulder balance #Hook of the upper instrumented vertebra

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참고문헌 (14)

참고문헌 신청
Danielsson AJ / 2003 / Back pain and function 23 years after fusion for adolescent idiopathic scoliosis : a case-control study-part II / Spine(Phila Pa 1976) 28:E373~E383 google schola Akazawa T / 2012 / Long-term clinical outcomes of surgery for adolescent idiopathic scoliosis 21 to 41 years later / Spine(Phila Pa 1976) 37:402~405 google schola Akazawa T / 2017 / Spinal fusion on adolescent idiopathic scoliosis patients with the level of L4 or lower can increase lumbar disc degeneration with sagittal imbalance 35 years after surgery / Spine Surg Relat Res 1:72~77 google schola Zhang S / 2018 / Incidence and risk factors for postoperative shoulder imbalance in scoliosis : a systematic review and meta-analysis / Eur Spine J 27:358~369 google schola Kuklo TR / 2002 / Correlation of radiographic, clinical, and patient assessment of shoulder balance following fusion versus nonfusion of the proximal thoracic curve in adolescent idiopathic scoliosis / Spine(Phila Pa 1976) 27:2013~2020 google schola

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