Kwan, Mun Keong and Lee, Sin Ying and Ch'ng, Pei Ying and Chung, Weng Hong and Chiu, Chee Kidd and Chan, Chris Yin Wei (2020) A positive (plus ve) postoperative upper instrumented vertebra tilt Angle (>= 0 degrees) significantly increases the risk of medial shoulder and neck imbalance in lenke 1 and 2 adolescent idiopathic scoliosis patients. SPINE, 45 (12). E694-E703. ISSN 0362-2436, DOI https://doi.org/10.1097/BRS.0000000000003407.
Full text not available from this repository.Abstract
Study Design. Retrospective study. Objective. To investigate the relationship between a +ve postoperative Upper Instrumented Vertebra (UIV) (>= 0 degrees) tilt angle and the risk of medial shoulder/neck and lateral shoulder imbalance among Lenke 1 and 2 Adolescent Idiopathic Scoliosis (AIS) patients following Posterior Spinal Fusion. Summary of Background Data. Current UIV selection strategy has poor correlation with postoperative shoulder balance. The relationship between a +ve postoperative UIV tilt angle and the risk of postoperative shoulder and neck imbalance was unknown. Methods. One hundred thirty-six Lenke 1 and 2 AIS patients with minimum 2 years follow-up were recruited.For medial shoulder and neck balance, patients were categorized into positive (+ve) imbalance (>=+4 degrees), balanced, or negative (-ve) imbalance (<=-4 degrees) groups based on T1 tilt angle/Cervical Axis measurement. Forlateral shoulder balance, patients were classified into +ve imbalance (>=+3 degrees) balanced, and -ve imbalance (<=-3 degrees) groups based on Clavicle Angle (Cla-A) measurement. Linear regression analysis identified the predictive factors for shoulder/neck imbalance. Logistic regression analysis calculated the odds ratio of shoulder/neck imbalance for patients with +ve postoperative UIV tilt angle. Results. Postoperative UIV tilt angle and preoperative T1 tilt angle were predictive of +ve medial shoulder imbalance. Postoperative UIV tilt angle and postoperative PT correction were predictive of +ve neck imbalance. Approximately 51.6% of patients with +ve medial shoulder imbalance had +ve postoperative UIV tilt angle. Patients with +ve postoperative UIV tilt angle had 14.9 times increased odds of developing +ve medial shoulder imbalance and 3.3 times increased odds of developing +ve neck imbalance. Postoperative UIV tilt angle did not predict lateral shoulder imbalance. Conclusion. Patients with +ve postoperative UIV tilt angle had 14.9 times increased odds of developing +ve medial shoulder imbalance (T1 tilt angle >=+4 degrees) and 3.3 times increased odds of developing +ve neck imbalance (cervical axis >=+4 degrees).
| Item Type: | Article |
|---|---|
| Funders: | UNSPECIFIED |
| Uncontrolled Keywords: | Adolescent idiopathic scoliosis; Lateral; Lenke 1 and 2; Medial; Neck; Positive; Posterior Spinal Fusion; Postoperative; Shoulder imbalance; Upper instrumented vertebra tilt angle |
| Subjects: | R Medicine > R Medicine (General) |
| Divisions: | Faculty of Medicine > Orthopaedic Surgery Department |
| Depositing User: | Ms Zaharah Ramly |
| Date Deposited: | 10 Jun 2025 04:08 |
| Last Modified: | 10 Jun 2025 04:08 |
| URI: | http://eprints.um.edu.my/id/eprint/36613 |
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