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Anchor type at upper instrumented vertebra and postoperative shoulder imbalance in patients with Lenke type 1 adolescent idiopathic scoliosis

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Abstract

Purpose

To clarify the impact of anchor type at upper instrumented vertebra (UIV) on postoperative shoulder imbalance in patients with Lenke type 1 adolescent idiopathic scoliosis (AIS) who underwent posterior spinal fusion.

Methods

Subjects were 81 patients with Lenke type 1 AIS who underwent posterior spinal fusion between 2004 and 2013. Twenty-five patients agreed to participate in the study. We divided the patients into two groups: Hook group (15 patients with hooks at UIV who underwent surgery between 2004 and 2011) and PS group (ten patients with pedicle screws at UIV who underwent surgery between 2012 and 2013). To evaluate shoulder balance, first thoracic vertebra tilt angle (T1 tilt), clavicle angle (CA), and radiographic shoulder height (RSH) were measured.

Results

There were no significant differences in preoperative T1 tilt, CA, or RSH between the both groups. The postoperative 1-week, 2-year, and most recently observed T1 tilts were significantly smaller in the Hook group than in the PS group. There were no significant differences in postoperative 1-week, 2-year, and most recently observed CAs between the two groups. Although there were no significant differences in 1-week postoperative RSH between the groups, the 2-year postoperative RSH was significantly smaller in the Hook group than in the PS group. The most recently observed RSH tended to be smaller in the Hook group than in the PS group, but the difference was not significant.

Conclusions

In the PS group, poor shoulder balance remained over the long term. The hooks at UIV adjusted postoperative shoulder balance.

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Availability of data and material

The datasets acquired and analyzed in this study will be disclosed by the corresponding author on reasonable request.

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Acknowledgements

The authors thank Mr. Hideo Ishikawa, Mr. Mitoshi Ishino, and Ms. Yuri Ichikawa for an assistance of data collection.

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Authors

Contributions

Tsutomu Akazawa wrote and prepared the manuscript, and all of the authors participated in the study design. All authors have read, reviewed, and approved the article.

Corresponding author

Correspondence to Tsutomu Akazawa.

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Conflict of interest

The authors declare that there are no conflicts of interest.

Ethics approval

Institutional review board of Seirei Sakura Citizen Hospital approved this study. Approval code: No. 30-018.

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The written informed consents were obtained.

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The written informed consents were obtained.

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Akazawa, T., Kuroya, S., Kotani, T. et al. Anchor type at upper instrumented vertebra and postoperative shoulder imbalance in patients with Lenke type 1 adolescent idiopathic scoliosis. Eur J Orthop Surg Traumatol 31, 245–251 (2021). https://doi.org/10.1007/s00590-020-02766-4

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  • DOI: https://doi.org/10.1007/s00590-020-02766-4

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