The effect of the caudal insertion angle of pedicle screws on postoperative thoracic kyphosis in adolescent idiopathic scoliosis: a pilot study
The study was a prospective analysis of collected data to compare the effect of the insertion angle (parallel or oblique relative to the upper-end plates) of thoracic pedicle screws on postoperative thoracic kyphosis in patients with idiopathic thoracic scoliosis. This study was conducted on idiopat...
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Published in | Journal of pediatric orthopaedics. B |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
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United States
01.11.2023
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Abstract | The study was a prospective analysis of collected data to compare the effect of the insertion angle (parallel or oblique relative to the upper-end plates) of thoracic pedicle screws on postoperative thoracic kyphosis in patients with idiopathic thoracic scoliosis. This study was conducted on idiopathic adolescent scoliosis (AIS) patients. Two groups of patients were defined according to the insertion angle of thoracic pedicle screws in relation to the upper-end plate of the corresponding vertebra, the insertion angles being either oblique or parallel. Seven consecutive AIS patients were compared in each group. Pre- and postoperative standing X-rays were obtained. Cobb's angles, sagittal parameters such as thoracic kyphosis (TK) (T1-T12) and lumbar lordosis (LL) (L1-S1) were all measured. The average of the main curve or compensatory curve corrections showed no significant differences between the two groups. From a sagittal profile perspective, the mean TK in the oblique screw group was 39.3 ± 11.5 preoperatively, which was reduced to 30.9 ± 6.41 after surgery. The mean TK in the parallel group was 36.4 ± 14 preoperatively and 42.1 ± 13.9 postoperatively. There was a significant reduction in TK in the oblique screws group compared with the second group ( P = 0.038). The insertion angle of pedicle screws had no significant effect on Cobb's angle and lumbar lordosis changes. However, oblique insertion of thoracic screws decreased thoracic kyphosis postoperatively, which could be considered a negative point. As such, the insertion of thoracic screws in a caudal direction should not be routinely used because of its lordogenic effect. |
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AbstractList | The study was a prospective analysis of collected data to compare the effect of the insertion angle (parallel or oblique relative to the upper-end plates) of thoracic pedicle screws on postoperative thoracic kyphosis in patients with idiopathic thoracic scoliosis. This study was conducted on idiopathic adolescent scoliosis (AIS) patients. Two groups of patients were defined according to the insertion angle of thoracic pedicle screws in relation to the upper-end plate of the corresponding vertebra, the insertion angles being either oblique or parallel. Seven consecutive AIS patients were compared in each group. Pre- and postoperative standing X-rays were obtained. Cobb's angles, sagittal parameters such as thoracic kyphosis (TK) (T1-T12) and lumbar lordosis (LL) (L1-S1) were all measured. The average of the main curve or compensatory curve corrections showed no significant differences between the two groups. From a sagittal profile perspective, the mean TK in the oblique screw group was 39.3 ± 11.5 preoperatively, which was reduced to 30.9 ± 6.41 after surgery. The mean TK in the parallel group was 36.4 ± 14 preoperatively and 42.1 ± 13.9 postoperatively. There was a significant reduction in TK in the oblique screws group compared with the second group ( P = 0.038). The insertion angle of pedicle screws had no significant effect on Cobb's angle and lumbar lordosis changes. However, oblique insertion of thoracic screws decreased thoracic kyphosis postoperatively, which could be considered a negative point. As such, the insertion of thoracic screws in a caudal direction should not be routinely used because of its lordogenic effect. |
Author | Moradi Shahrbabak, Mahdi Keyhaninejad, Nima Karami, Mohsen Eghbali, Ahmad Khaleghnejad Tabari, Ahmad |
Author_xml | – sequence: 1 givenname: Mohsen surname: Karami fullname: Karami, Mohsen organization: Pediatric Surgery Research Center, Research Institute for Children's Health – sequence: 2 givenname: Ahmad surname: Eghbali fullname: Eghbali, Ahmad organization: Anesthesiology Research Center, Mofid Children Hospital – sequence: 3 givenname: Ahmad surname: Khaleghnejad Tabari fullname: Khaleghnejad Tabari, Ahmad organization: Pediatric Surgery Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences – sequence: 4 givenname: Mahdi surname: Moradi Shahrbabak fullname: Moradi Shahrbabak, Mahdi organization: Shahid Beheshti University of Medical Sciences, Tehran, Iran – sequence: 5 givenname: Nima surname: Keyhaninejad fullname: Keyhaninejad, Nima organization: Shahid Beheshti University of medical sciences, Tehran, Iran |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/36445354$$D View this record in MEDLINE/PubMed |
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Title | The effect of the caudal insertion angle of pedicle screws on postoperative thoracic kyphosis in adolescent idiopathic scoliosis: a pilot study |
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