PMID- 25373492
OWN - NLM
STAT- MEDLINE
DCOM- 20150720
LR  - 20220311
IS  - 1471-2474 (Electronic)
IS  - 1471-2474 (Linking)
VI  - 15
DP  - 2014 Nov 5
TI  - Postoperative shoulder imbalance in Lenke Type 1A adolescent idiopathic scoliosis 
      and related factors.
PG  - 366
LID - 10.1186/1471-2474-15-366 [doi]
LID - 366
AB  - BACKGROUNDS: The purpose of this study was to investigate the occurrence and 
      factors associated with postoperative shoulder imbalance (PSI) in Lenke type 1A 
      curve. METHODS: This study included 106 patients with Lenke Type 1A curve who 
      were followed up more than two years after posterior correction surgery. Pedicle 
      screw (PS) constructs were used in 84 patients, and hybrid constructs in 22. The 
      upper instrumented vertebra was rostral to the upper-end vertebra (UEV) in 70 
      patients, at UEV in 26, and below UEV in 10. The clavicle angle and T1 tilt angle 
      were measured as PSI indicators, and correlations between radiographic parameters 
      of shoulder balance and other radiographic parameters and associations between 
      PSI and clinical parameters were investigated. For statistical analyses, paired 
      and unpaired t-tests were used. RESULTS: The mean Cobb angles of the main and 
      proximal thoracic curves were 54.6 +/- 9.5 and 26.7 +/- 7.9 degrees before surgery, 
      14.5 +/- 7.5, and 14.9 +/- 7.1 at follow-up. Clavicle angle and T1 tilt angle were 
      -2.9 +/- 2.8 and -2.6 +/- 6.3 before surgery, 2.4 +/- 2.8 and 4.4 +/- 4.3 immediately 
      after surgery, and 1.8 +/- 2.1 and 3.4 +/- 5.5 at follow-up. Twenty patients 
      developed distal adding-on. Clavicle angle at follow-up correlated weakly but 
      significantly with preoperative clavicle angle (r = 0.34, p = 0.001) and with the 
      correction rates of the main thoracic curve (r = 0.34, p = 0.001); it correlated 
      negatively with the proximal curve spontaneous correction rate (r=-0.21, p = 
      0.034). The clavicle angle at follow-up was significantly larger in patients with 
      PS-only constructs (PS 2.1 degrees vs. hybrid 0.9, p = 0.02), and tended to be 
      smaller in patients with distal adding-on (adding-on 1.1 vs. non adding-on 2.0, p 
      = 0.09). CONCLUSIONS: PSI was more common with better correction of the main 
      curve (using PS constructs), in patients with a larger preoperative clavicle 
      angle, and with a larger and more rigid proximal curve. Distal adding-on may 
      compensate for PSI.
FAU - Matsumoto, Morio
AU  - Matsumoto M
AD  - Department of Orthopaedic Surgery, Keio University, Shinanomachi 35, Shinjuku-ku, 
      Tokyo #160-8582, Japan. morio@a5.keio.jp.
FAU - Watanabe, Kota
AU  - Watanabe K
FAU - Kawakami, Noriaki
AU  - Kawakami N
FAU - Tsuji, Taichi
AU  - Tsuji T
FAU - Uno, Koki
AU  - Uno K
FAU - Suzuki, Teppei
AU  - Suzuki T
FAU - Ito, Manabu
AU  - Ito M
FAU - Yanagida, Haruhisa
AU  - Yanagida H
FAU - Minami, Shohei
AU  - Minami S
FAU - Akazawa, Tsutomu
AU  - Akazawa T
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20141105
PL  - England
TA  - BMC Musculoskelet Disord
JT  - BMC musculoskeletal disorders
JID - 100968565
SB  - IM
MH  - Adolescent
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Orthopedic Procedures/adverse effects
MH  - Postoperative Complications/*diagnostic imaging/etiology
MH  - *Postural Balance
MH  - Radiography
MH  - Retrospective Studies
MH  - Scoliosis/*diagnostic imaging/*surgery
MH  - Shoulder/*diagnostic imaging/*surgery
MH  - Thoracic Vertebrae/diagnostic imaging/surgery
MH  - Young Adult
PMC - PMC4230354
EDAT- 2014/11/07 06:00
MHDA- 2015/07/21 06:00
PMCR- 2014/11/05
CRDT- 2014/11/07 06:00
PHST- 2014/09/20 00:00 [received]
PHST- 2014/10/24 00:00 [accepted]
PHST- 2014/11/07 06:00 [entrez]
PHST- 2014/11/07 06:00 [pubmed]
PHST- 2015/07/21 06:00 [medline]
PHST- 2014/11/05 00:00 [pmc-release]
AID - 1471-2474-15-366 [pii]
AID - 2301 [pii]
AID - 10.1186/1471-2474-15-366 [doi]
PST - epublish
SO  - BMC Musculoskelet Disord. 2014 Nov 5;15:366. doi: 10.1186/1471-2474-15-366.