Dataset Information

Rod derotation and translation techniques provide comparable functional outcomes for surgical correction of adolescent idiopathic scoliosis - A retrospective, cross-sectional study.

ABSTRACT:

Objectives

To compare the functional outcome of the two most commonly used methods of Adolescence Idiopathic Scoliosis (AIS) correction surgery using rod rotation and translation techniques from a single center in Indonesia.

Method

We performed retrospective, cross-sectional study of patients with AIS who underwent deformity correction surgery by either technique in Fatmawati General Hospital from January 2016 to March 2018. All patients were asked to complete scoliosis research society (SRS)-22 questionnaire.

Result

Both methods of surgical correction yielded similar functional outcome as recorded in SRS-22 score, 3.67 for rod derotation technique and 3.44 for translation technique (p = 0.235).

Conclusion

Both rod derotation and translation technique resulted in equally desirable quality of life for AIS patients, in line with what would be expected from the literatures. Neither technique can be judged superior to the other. Therefore, the decision to use rotation or translation technique, as well as to compliment it with additional correction methods, should be made by the surgeon according to personal preference, experience, and comfort.

SUBMITTER: Librianto D

PROVIDER: S-EPMC8767236 | biostudies-literature | 2022 Jan

REPOSITORIES: biostudies-literature

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Publications

Rod derotation and translation techniques provide comparable functional outcomes for surgical correction of adolescent idiopathic scoliosis - A retrospective, cross-sectional study.

Librianto Didik D Saleh Ifran I Fachrisal Utami Widyastuti Srie WS Hutami Witantra Dhamar WD

Annals of medicine and surgery (2012) 20211226

<h4>Objectives</h4>To compare the functional outcome of the two most commonly used methods of Adolescence Idiopathic Scoliosis (AIS) correction surgery using rod rotation and translation techniques from a single center in Indonesia.<h4>Method</h4>We performed retrospective, cross-sectional study of patients with AIS who underwent deformity correction surgery by either technique in Fatmawati General Hospital from January 2016 to March 2018. All patients were asked to complete scoliosis research s ...[more]

PMID: 35070277

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Project description:BackgroundCurrent methods of measuring vertebral rotation by plain radiographs rely on anatomic landmarks that are not present in the postoperative spine or require advanced imaging. Furthermore, there are few studies on the incidence of crankshaft with modern pedicle instrumentation.Questions/purposesWe sought to (1) describe and validate a method of vertebral rotation measurement using plain radiographs and (2) measure postoperative rotation in a series of patients treated for adolescent idiopathic scoliosis.MethodsPatients with adolescent idiopathic scoliosis treated with surgery over a 6-year period were reviewed. Patients with computed tomography (CT) scans and radiographs within 60 days of another were included. Vertebral rotation was calculated by radiographic measurements and measured directly by CT scan. As an internal control, patients with two apical pedicle screws on all radiographs were analyzed. Rotation was measured for all patients with at least 1 year of radiographic follow-up.ResultsThree thousand five hundred fifty-two instrumented spinal levels in 308 consecutive patients were reviewed. Ten patients with 93 screws were analyzed by CT and radiographs. The average discrepancy between computed tomography (CT) and radiographs was 3.3 ± 1.9°, with 81.7% (76/93) within 5°. Intra- and inter-rater reliabilities for measured axial rotation were excellent (intra-class correlation coefficient (ICC) = 0.879 and 0.900, respectively). One hundred swventy-eight patients were eligible with an average follow-up of 2.3 ± 1.2 years; 84.8% (151/178) had screw(s) visible on all images at the major curve apex. The average postsurgical rotation was 3.5 ± 2.9°; 19.2% (29/151) were measured to have a rotation over 5°, and 4.0% (6/151) demonstrated a rotation over 10°. Only 4.6% (7/151) of patients demonstrated a postoperative Cobb angle change over 10°.ConclusionsMost major curves have apical pedicle screw instrumentation that can be followed by radiographs alone to measure rotation. Vertebral rotation measurement requires only plain radiographs and is a more sensitive determination for subtle postoperative crankshaft than change in Cobb angle.

Project description:Adolescent Idiopathic Scoliosis (AIS) is the most common orthopedic condition requiring surgery, affecting 4% of adolescents. There is currently no proven method or prognostic test to identify symptomatic patients at risk of developing severe scoliosis who could benefit from growth-guided devices or minimally invasive non-fusion instrumentation surgeries. These innovative treatments must be performed at an early disease stage in younger patients to benefit from their growth potential. In this prospective cross-sectional study, we investigated the clinical utility of circulating microRNAs (miRNAs), an important class of small non-coding RNA, as biomarkers to predict the risk of developing severe scoliosis in AIS. Blood samples and clinical data were collected from 116 AIS patients who were followed until skeletal maturity and stratified according to their clinical outcome. Genome-wide expression profiling of miRNAs was performed with plasma obtained at the time of diagnosis of AIS (mean age of 13.3 ± 1.7 years with a mean Cobb angle of 24.4° ± 12.4°). This approach led to the identification of 15 circulating miRNAs that are upregulated in AIS patients who developed a severe scoliosis (Cobb angle ≥45°) at skeletal maturity compared to moderate and mild scoliosis groups (Cobb angle between 25°-44° and <25° respectively). After optimization and the application of Random Forest Models a panel of six miRNAs (miR-1-3p, miR-19a-3p, miR-19b-3p, miR-133b, miR-143-3p, and miR-148b-3p) out of 15 led us to develop an algorithm predicting the risk of developing a severe scoliosis with great accuracy (100%), sensitivity (100%) and specificity (100%). Having a scoliosis predictive bioassay and decision-making tools to predict curve progression in order to find the best treatment plan will undoubtedly transform the orthopedic care system in the field of pediatric scoliosis by integrating innovative precision medicine approaches. In addition, investigation of genes targeted by these miRNAs could fill our gaps in our understanding of AIS pathogenesis and reveal new actionable targets.

Dataset Information

Rod derotation and translation techniques provide comparable functional outcomes for surgical correction of adolescent idiopathic scoliosis - A retrospective, cross-sectional study.

Objectives

Method

Result

Conclusion

Publications

Rod derotation and translation techniques provide comparable functional outcomes for surgical correction of adolescent idiopathic scoliosis - A retrospective, cross-sectional study.

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