The Impact of Relative Curve Correction on Postoperative Shoulder Balance in Adolescent Idiopathic Scoliosis | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 178, Volume 94, Issue 1, January 2024, Page 1212-1217 PDF (291.36 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2024.347523 | ||||
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| Abstract | ||||
| Background: Postoperative shoulder asymmetry frequently emerges as a prevalent adverse outcome following the surgical rectification of adolescent idiopathic scoliosis (AIS). Objective: This study aimed to evaluate the influence exerted by the degree of rectification of the primary thoracic (MT) and proximal thoracic (PT) curvatures in correlation with one another on the equilibrium of the shoulders following surgical intervention. Patients and methods:Fifteen patients harbouring AIS curvatures underwent correction via pedicle screw/rod constructs. The determinants of postoperative shoulder disparity were pinpointed through univariate examination. Furthermore, to ascertain the autonomous predictors of shoulder asymmetry, a multivariate assessment was conducted employing the classification and regression tree technique. Results: Post-surgical observation revealed that a third of the patients (33.3%) experienced shoulder imbalance. In instances where the correction of the PT Cobb angle surpassed 52%, the majority (57%) exhibited shoulder equilibrium. In a similar vein, when the correction of the PT curve was inferior to 52% and the correction of MT curve did not exceed 67%, a significant 86% of the subjects achieved shoulder balance. Conversely, with the PT curve correction falling below 52% and the MT curve correction exceeding 67%, only half of the patients attained balanced shoulders. Conclusions: Within the context of AIS deformities, a pronounced rectification of the main thoracic curve (67%) accompanied by a concurrent 'under-correction' (<52%) of the upper thoracic curve precipitated a disparity in shoulder height in half of the patients, irrespective of UIV placement. | ||||
| Keywords | ||||
| AIS; Curve correction; Deformity; Lenke type; Shoulder balance; Scoliosis; Shoulder imbalance; Surgery; Upper instrumented vertebra | ||||
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