PMID- 30299417
OWN - NLM
STAT- MEDLINE
DCOM- 20190516
LR  - 20210115
IS  - 1528-1159 (Electronic)
IS  - 0362-2436 (Linking)
VI  - 44
IP  - 8
DP  - 2019 Apr 15
TI  - How Common Is Medial and Lateral Shoulder Discordance in Lenke 1 and 2 Curves?: A 
      Preoperative Analysis of Medial and Lateral Shoulder Balance Among 151 Lenke 1 
      and 2 Adolescent Idiopathic Scoliosis Patients.
PG  - E480-E486
LID - 10.1097/BRS.0000000000002890 [doi]
AB  - STUDY DESIGN: Retrospective study of prospectively collected data. OBJECTIVE: To 
      analyze the incidence and the patterns of medial and lateral shoulder discordance 
      among Lenke 1 and 2 patients. SUMMARY OF BACKGROUND DATA: Postoperative shoulder 
      imbalance (PSI) is still common in Lenke 1 and 2 adolescent idiopathic scoliosis 
      (AIS). This could be due to presence of medial dan lateral shoulder discordance. 
      METHODS: One hundred fifty-one Lenke 1 and 2 AIS patients were recruited. Lenke 1 
      curves were subclassified into Lenke 1-ve (flexible) (proximal thoracic side 
      bending [PTSB] Cobb angle <15 degrees ) and 1+ve curves (stiff) (PTSB Cobb angle between 
      15 degrees  and 24.9 degrees ). T1 tilt represented "medial shoulder balance" and radiological 
      shoulder height (RSH) represented "lateral shoulder balance." We categorized 
      patients into three concordant shoulder pattern types (medial balanced/lateral 
      balanced [MBLB], medial imbalanced+ve/lateral imbalanced+ve (MI+ve/LI+ve), medial 
      imbalanced-ve/lateral Imbalanced-ve (MI-ve/LI-ve), and six discordant shoulder 
      pattern types. RESULTS: The mean age was 16.2 +/- 5.7 years. Eighty-one patients 
      (53.6%) had concordant pattern and 70 patients (46.4%) had discordant pattern. 
      Lateral shoulder imbalance was noted in 35.1% of patients and medial shoulder 
      imbalance in 43.7% of patients. In Lenke 1-ve curves, 35 patients (68.6%) had 
      concordant shoulder imbalance with medial imbalanced-ve/lateral imbalanced-ve 
      (MI-ve/LI-ve) being the commonest pattern (68.6%). In Lenke 1+ve curves, 33 
      patients (55.0%) had concordant shoulder pattern with medial balanced/lateral 
      balanced (MB/LB) being the commonest type (57.6%). In Lenke 2 AIS, 27 patients 
      (67.5%) had discordant pattern with medial imbalanced+ve/lateral balanced 
      (MI+ve/LB) being the commonest pattern (44.4%) (P value = 0.002). CONCLUSION: 
      46.4% Lenke 1 and 2 AIS patients had shoulder discordant pattern. This was more 
      prevalent in Lenke 2 curves (67.5%). In Lenke 1-ve (flexible) curves, MI-ve/LI-ve 
      pattern was the commonest pattern. In Lenke 1+ve curves (stiff), there were 
      almost equal number of concordant and discordant shoulder pattern. In Lenke 2 
      patients, the most common pattern was MI+ve/LB. LEVEL OF EVIDENCE: 4.
FAU - Chung, Weng Hong
AU  - Chung WH
AD  - Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for 
      Research and Learning (NOCERAL), Faculty of Medicine, University of Malaya, Kuala 
      Lumpur, Malaysia.
FAU - Chiu, Chee Kidd
AU  - Chiu CK
FAU - Ng, Sherwin Johan
AU  - Ng SJ
FAU - Goh, Saw Huan
AU  - Goh SH
FAU - Chan, Chris Yin Wei
AU  - Chan CYW
FAU - Kwan, Mun Keong
AU  - Kwan MK
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Spine (Phila Pa 1976)
JT  - Spine
JID - 7610646
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Female
MH  - Humans
MH  - Male
MH  - Postoperative Period
MH  - Radiography
MH  - Retrospective Studies
MH  - Scoliosis/*surgery
MH  - Shoulder/*diagnostic imaging
MH  - Thoracic Vertebrae/*diagnostic imaging
MH  - Young Adult
EDAT- 2018/10/10 06:00
MHDA- 2019/05/17 06:00
CRDT- 2018/10/10 06:00
PHST- 2018/10/10 06:00 [pubmed]
PHST- 2019/05/17 06:00 [medline]
PHST- 2018/10/10 06:00 [entrez]
AID - 00007632-201904150-00011 [pii]
AID - 10.1097/BRS.0000000000002890 [doi]
PST - ppublish
SO  - Spine (Phila Pa 1976). 2019 Apr 15;44(8):E480-E486. doi: 
      10.1097/BRS.0000000000002890.