지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2024.9
- 수록면
- 903 - 912 (10page)
- DOI
- 10.14245/ns.2448544.272
이용수
초록· 키워드
오류제보하기
Objective: To explore the changes in coronal imbalance (CIB) in Lenke 5C adolescent idiopathic scoliosis (AIS) after posterior selective fusion surgery and determine their implications for surgical decision-making.
Methods: One hundred twenty patients were categorized according to the preoperative coronal pattern (type A, coronal balance distance [CBD] < 20 mm; type B, CBD ≥ 20 mm and coronal C7 plumbline [C7PL] shifted to the concave side of the curve; type C, CBD ≥ 20 mm and C7PL shifted to the convex side of the curve). CIB group (CIB+) was defined as having a CBD ≥ 20 mm at the 2-year follow-up.
Results: Compared to type A patients, the prevalence of postoperative CIB was higher in type C patients both immediately postoperative (22% vs. 38%, p < 0.05) and at the final follow-up (5% vs. 29%, p < 0.05), whereas type A patients showed a greater improvement in CBD (9 of 12 vs. 6 of 24, p < 0.05) at the final follow-up. The majority of patients in all groups had recovered to type A at the final follow-up (96 of 120). The proximal Cobb-1 strategy reduced the incidence of postoperative CIB (1 of 38) at the 2-year follow-up, especially in preoperative type C patients. Multivariate logistic regression analysis revealed that type C and overcorrection of the thoracolumbar curve were risk factors for CIB at the 2-year follow-up (p = 0.007 and p = 0.026, respectively).
Conclusion: Patients with type C CIB in AIS exhibited unsatisfactory restoration, with 29% of them exhibiting CIB at the final follow-up. The selective fusion strategy of proximal Cobb-1 may reduce the risk of postoperative CIB especially when the preoperative coronal pattern is type C.
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