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Evaluating the Change in Axial Vertebral Rotation Following Thoracoscopic Anterior Scoliosis Surgery Using Low-Dose Computed Tomography

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Abstract

Background Context

In recent years, there has been increasing appreciation of the need to treat scoliosis as a three-dimensional deformity.

Purpose

Assessment of surgical strategies and outcomes should consider not only the coronal plane correction but also derotation of the transverse plane deformity that can affect trunk appearance.

Study Design

This study included a cohort of 29 female adolescent idiopathic scoliosis patients who received thoracoscopic single rod anterior fusion (TASF) surgery. This study used pre- and postoperative low-dose computed tomographic (CT) scans to accurately measure apical axial vertebral rotation (AVR).

Methods

The pre- and postoperative values for clinically measured coronal Cobb correction and rib hump correction as well as AVR were compared to determine whether these values improved postoperatively. There are no conflicts of interest to report for authors of this investigation.

Results

As expected, statistically significant reductions in coronal Cobb angle (mean preoperative Cobb 51°, reducing to 24° at the two-year follow-up) and rib hump (mean preoperative rib hump 15°, reducing to 7° at two-year follow-up) were achieved. The mean reduction in apical AVR measured using CT was only 3° (mean preoperative AVR 16°, reducing to 13° at two-year follow-up), which was statistically but not clinically significant. Significant correlations were found between Cobb angle and rib hump, between Cobb angle and AVR, and between AVR and rib hump, suggesting that patients with greater coronal Cobb correction also achieve better derotation with this surgical procedure.

Conclusions

The historical low-dose CT data set permitted detailed three-dimensional assessment of the deformity correction that is achieved using thoracoscopic anterior spinal fusion for progressive adolescent idiopathic scoliosis.

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Authors and Affiliations

  1. Paediatric Spine Research Group, Institute of Health and Biomedical Innovation-Centre for Children’s Health Research, Queensland University of Technology and Mater Health Services, 62 Graham Street, South Brisbane, Queensland, 4101, Australia

    J. Paige Little PhD, Maree T. Izatt BPhty, Clayton J. Adam PhD, Olivia Lofgren, Anna Sundberg, Robert D. Labrom MSc, FRACS & Geoffrey N. Askin FRACS

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  1. J. Paige Little PhD
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  2. Maree T. Izatt BPhty
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  3. Clayton J. Adam PhD
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  4. Olivia Lofgren
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  5. Anna Sundberg
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  6. Robert D. Labrom MSc, FRACS
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  7. Geoffrey N. Askin FRACS
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Corresponding author

Correspondence to J. Paige Little PhD.

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Author disclosures

JPL (support for trips/travel from NuVasive; research support from Medtronic and Synthes; grants from Medical Advances without Animals); MTI (institutional support for trips/travel from NuVasive, institutional support for research from Medtronic); CJA (support for trips/travel from NuVasive; researcher support salaries and materials from Synthes and Medtronic; and a European Union Fellowship FP7-PEOPLE-2010-IIF-274964 salary 2012–13); OL (none); AS (none); RDL (support for speaking and/or teaching arrangements from Medtronic; researcher support salaries from Medtronic and Synthes; and fellowship support from DePuy Synthes), GNA (support for speaking and/or teaching arrangements from Medtronic; researcher support salaries from Medtronic and Synthes).

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Little, J.P., Izatt, M.T., Adam, C.J. et al. Evaluating the Change in Axial Vertebral Rotation Following Thoracoscopic Anterior Scoliosis Surgery Using Low-Dose Computed Tomography. Spine Deform 5, 172–180 (2017). https://doi.org/10.1016/j.jspd.2016.12.003

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  • DOI: https://doi.org/10.1016/j.jspd.2016.12.003

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