Abstract
PurposeTo clarify if CCI or FBCI could fully eliminate the influence of curve flexibility on the coronal correction rate.MethodsWe reviewed medical record of all thoracic curve AIS cases undergoing posterior spinal fusion with all pedicle screw systems from June 2011 to July 2013. Radiographical data was collected and calculated. Student t test, Pearson correlation analysis and linear regression analysis were used to analyze the data.Results60 were included in this study. The mean age was 14.7y (10-18y) with 10 males (17%) and 50 females (83%). The average Risser sign was 2.7. The mean thoracic Cobb angle before operation was 51.9°. The mean bending Cobb angle was 27.6° and the mean fulcrum bending Cobb angle was 17.4°. The mean Cobb angle at 2 week after surgery was 16.3°. The Pearson correlation coefficient r between CCI and BFR was -0.856(P<0.001), and between FBCI and FFR was -0.728 (P<0.001). A modified FBCI (M-FBCI) = (CR-0.513)/BFR or a modified CCI (M-CCI) = (CR-0.279)/FFR was generated by curve estimation has no significant correlation with FFR (r=-0.08, p=0.950) or with BFR (r=0.123, p=0.349).ConclusionsFulcrum-bending radiographs may better predict the outcome of AIS coronal correction than bending radiographs in thoracic curveAIS patients. Neither CCI nor FBCI can fully eliminate the impact of curve flexibility on the outcome of correction. A modified CCI or FBCI can better evaluating the corrective effects of different surgical techniques or instruments.
Highlights
Adolescent idiopathic scoliosis(AIS) is a complex three-dimensional deformation of the spine
A modified FBCI (M-FBCI) = (CR-0.513)/BFR or a modified CCI (M-CCI) = (CR-0.279)/FFR was generated by curve estimation has no significant correlation with FFR (r=-0.08, p=0.950) or with BFR (r=0.123, p=0.349)
Fulcrum-bending radiographs may better predict the outcome of AIS coronal correction than bending radiographs in thoracic curveAIS patients
Summary
Adolescent idiopathic scoliosis(AIS) is a complex three-dimensional deformation of the spine. The transpedicular screw system is currently widely used for surgical correction of AIS. It is reported in the literature that posterior correction and fusion with pedicular screws in the treatment of AIS can enhance the correction rate, though results vary between different studies [1,2,3,4,5]. Most of these series case reports did not take preoperative flexibility into account. Regardless of the instrument system used, patients with flexible curves have better correction rates than those with rigid curves. The corrective ability of different instruments used between groups are often difficult to compare [6]
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