Analysis of Risk Factors for Distal Adding-on Phenomenon in Lenke 1,2 Adolescent Idiopathic Scoliosis
Objective To investigate the efficacy of different lower instrumented vertebra(LIV)choices in the treatment of Lenke 1 and 2 adolescent idiopathic scoliosis(AIS),and to further analyze the risk factors affecting the occurrence of postoperative distal adding-on phenomenon(AO).Methods The medical records of a total of 94 patients with Lenke types 1 and 2 who underwent orthopedic spine surgery from January 2015 to January 2021 were retrospectively analyzed.According to the relative position of LIV and SV,patients were categorized into three groups,SV＜-1,SV-1,and SV ≥0.All patients had standing posteroanterior and lateral radiographs preoperatively,immediately after surgery,and at the final follow-up,and each imaging parameter was measured before and after surgery.The patients were divided into two groups according to the occurrence of the distal AO at the final follow-up,and the risk factors for its occurrence were further analyzed.Results 94 patients with AIS were followed up for(30.40±5.59)months(24-48 months),and distal AO occurred in 13 patients(13.8％)at the last follow-up:8 SV＜-1(44.4％),3 SV-1(10.7％)and 2 SV ≥ 0(4.2％).Factors that showed statistically significant differences between the two groups by univariate analysis included preopera-tive LIV+1 offset CSVL distance,postoperative parietal offset distance,main thoracic kyphosis Cobb angle cor-rection rate in the immediate postoperative period and at the final follow-up,lumbar kyphosis Cobb angle cor-rection rate at the final follow-up,Risser's sign,and LIV-SV segmental gap(P all＜0.05).Variables with sta-tistically significant differences were analyzed by Logistic regression,and the differences in preoperative LIV+1 offset CSVL distance,Risser's sign(grade 0-2),and LIV-SV segmental gap(LIV-SV＜-1)were statistically significant(P all＜0.05).Conclusion Preoperative LIV+1 offset CSVL distance,Risser's sign,and LIV-SV segmental gap were independent risk factors influencing the occurrence of distal AO.LIV selection at least one vertebra proximal to the stabilized vertebrae(SV-1)can prevent the occurrence of distal AO.
adolescent idiopathic scoliosisLenke type 1 and 2lowest instrumented vertebradistal adding-on phenomenon
万方数据
维普
