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Disc wedging below lowest instrumented vertebra remains stable at 2 years
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A recently published retrospective chart and radiographic review showed disc wedging below the lowest instrumented vertebra, when compared with prone intraoperative fluoroscopic images, remains stable 2 years postoperatively based on standing radiographs for patients with adolescent idiopathic scoliosis. However, improvement in the tilt of the lowest instrumented vertebra was not maintained.
Researchers identified 163 patients with adolescent idiopathic scoliosis (AIS) who underwent posterior spinal fusion. Seventeen patients with fusion of structural lumbar curves, adequate imaging and a minimum 2-year follow up were included in the final study.
The disc angle improved from 5.4° preoperatively to 2.5° intraoperatively in the fluoroscopic imaging and it maintained the improvement at 2-year follow (2.8°) on the final standing postoperative image.
The mean lowest instrumented vertebra (LIV)-tilt was 19.4° preoperatively, which improved to 3.6° on the fluoroscopic image. However, this improvement was not maintained at 2-year follow up. The average tilt progressed to 8.6°, which was statistically significant progression (P = .004).
Coronal balance improved from 17.9 mm to 11.1 mm following surgery and was maintained through the 2-year follow up.
The investigators concluded LIV-tilt in patients with AIS with structural lumbar curves does not maintain its improvement at 2-year follow up, but disc wedging below LIV remains stable at 2-years follow up on standing radiographs. – by Robert Linnehan
Disclosure: The researchers report no relevant financial disclosures.
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