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European Spine Journal

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09-03-2024 | Scoliosis | Original Article

Progressive coronal caudal curve after corrective osteotomies for congenital cervicothoracic scoliosis: incidence and predictors

Authors: Ziqun Liu, Bin Jiang, Yifang Jiang, Yawei Li, Yuliang Dai, Lei Li, Yupeng Zhang, Zhenzhong Zheng, Bing Wang

Published in: European Spine Journal | Issue 4/2024

Abstract

Objective

Postoperative progressive coronal caudal curve (PCC) was characterized by a postoperative de novo caudal S-curve ≥ 20° following congenital cervicothoracic scoliosis (CTS) corrective osteotomies, and at least 20° greater than the preoperative measurement, while the incidence was uncertain and the pathogenesis was equivocal. The objective of this study was to investigate the morbidity and potential factors contributing to PCC following CTS surgery.

Methods

This study reviewed 72 CTS patients between 2005 and 2021. Patients were categorized into two groups according to the absence or presence of PCC at last follow-up, namely the nonprogressive curve group (NPC-group) and the progressive curve group (PC-group). Demographics, radiographic data and the Scoliosis Research Society-22 (SRS-22) questionnaire results were reviewed. Multivariate linear regression analyses were utilized to determine possible predictors for PCC.

Results

PCC was observed in 11 (15%) of the total 72 patients. Compared with the NPC-group, the PC-group exhibited greater postoperative residual local curve (24.0 ± 9.7° vs. 9.1 ± 4.4°, P < 0.001), upper instrumented vertebra (UIV) tilt (16.9 ± 7.4° vs. 6.2 ± 3.7°, P < 0.001), T1 tilt (14.3 ± 9.4° vs. 6.6 ± 3.9°, P = 0.022) and neck tilt (10.1 ± 6.7° vs. 3.7 ± 2.5, P = 0.009). The multivariable linear regression demonstrated that the larger postoperative UIV tilt, residual local curve and neck tilt were associated with PCC. In addition, patients with PCC showed lower SRS-22 scores in terms of pain, mental health, self-image and satisfaction (P < 0.05).

Conclusions

The morbidity of PCC was 15% in CTS patients who underwent corrective osteotomies. Greater residual local curve, postoperative UIV tilt and neck tilt were identified as predictors for PCC.

Payne WK 3rd, Ogilvie JW, Resnick MD, Kane RL, Transfeldt EE, Blum RW (1997) Does scoliosis have a psychological impact and does gender make a difference? Spine 22:1380–1384. https://doi.org/10.1097/00007632-199706150-00017CrossRefPubMed

Savvides P, Gerdhem P, Grauers A, Danielsson A, Diarbakerli E (2020) Self-experienced trunk appearance in individuals with and without idiopathic scoliosis. Spine 45:522–527. https://doi.org/10.1097/brs.0000000000003308CrossRefPubMed

Wang S, Zhang J, Zhang Y, Du Y, Yang Y, Lin G (2021) Outcomes of posterior lumbar hemivertebra resection and short fusion in patients with severe sacral tilt. Neurospine 18:562–569. https://doi.org/10.14245/ns.2142376.188CrossRefPubMedPubMedCentral

Zhao S, Xue X, Li K, Miao F, Zhao B (2021) Two-staged posterior osteotomy surgery in complex and rigid congenital scoliosis in younger than 10 years old children. BMC Musculoskelet Disord 22:788. https://doi.org/10.1186/s12891-021-04682-yCrossRefPubMedPubMedCentral

Chen Z, Qiu Y, Zhu Z, Li S, Chen X, Xu L, Sun X (2018) Posterior-only hemivertebra resection for congenital cervicothoracic scoliosis: correcting neck tilt and balancing the shoulders. Spine 43:394–401. https://doi.org/10.1097/BRS.0000000000002325CrossRefPubMed

Wang S, Lin G, Yang Y, Cai S, Zhuang Q, Tian Y, Zhang J (2019) Outcomes of 360° osteotomy in the cervicothoracic spine (C7–T1) for congenital cervicothoracic kyphoscoliosis in children. J Bone Joint Surg Am 101:1357–1365. https://doi.org/10.2106/jbjs.18.01428CrossRefPubMed

Zhang HQ, Du YX, Liu JY, Deng A, Wu JH, Wang YX, Guo CF (2022) Strategy and efficacy of surgery for congenital cervicothoracic scoliosis with or without hemivertebra osteotomy. Orthop Surg 14:2050–2058. https://doi.org/10.1111/os.13480CrossRefPubMedPubMedCentral

Huang Y, Feng G, Liu L, Yang X, Song Y, Zhou C, Wang L, Zhou Z (2019) Posterior hemivertebral resection for upper thoracic congenital scoliosis: be aware of high risk of complications. J Pediatr Orthop B 28:1–9. https://doi.org/10.1097/bpb.0000000000000538CrossRefPubMed

Sebaaly A, Daher M, Salameh B, Ghoul A, George S, Roukoz S (2022) Congenital scoliosis: a narrative review and proposal of a treatment algorithm. EFORT Open Rev 7:318–327. https://doi.org/10.1530/EOR-21-0121CrossRefPubMedPubMedCentral

10.

Chang DG, Suk SI, Kim JH, Ha KY, Na KH, Lee JH (2015) Surgical outcomes by age at the time of surgery in the treatment of congenital scoliosis in children under age 10 years. Spine J 15:1783–1795. https://doi.org/10.1016/j.spinee.2015.04.009CrossRefPubMed

11.

Yu M, Diao Y, Sun Y, Zhang F, Pan S, Chen X, Zhou F, Zhao Y, Xu N (2019) Evaluation of a combined approach to the correction of congenital cervical or cervicothoracic scoliosis. Spine J 19:803–815. https://doi.org/10.1016/j.spinee.2018.11.006CrossRefPubMed

12.

Le Huec JC, Aunoble S, Philippe L, Nicolas P (2011) Pelvic parameters: origin and significance. Eur Spine J 20(Suppl 5):564–571. https://doi.org/10.1007/s00586-011-1940-1CrossRefPubMedPubMedCentral

13.

Winter RB (1988) Congenital scoliosis. Orthop Clin North Am 19:395–408CrossRefPubMed

14.

Lin Y, Tan H, Rong T, Chen C, Shen J, Liu S, Yuan W, Cong H, Chen L, Luo J, Kwan KYH (2019) Impact of thoracic cage dimension and geometry on cardiopulmonary function in patients with congenital scoliosis: a prospective study. Spine 44:1441–1448. https://doi.org/10.1097/BRS.0000000000003178CrossRefPubMed

15.

Cao S, Chen X, Pan S, Diao Y, Zhao Y, Xia T, Li W, Zhou F, Sun Y (2022) Evaluation and comparation of a novel surgical technique and hemivertebra resection to the correction of congenital cervical scoliosis in lower cervical and cervicothoracic spine. Neurospine 19:1071–1083. https://doi.org/10.14245/ns.2244554.277CrossRefPubMedPubMedCentral

16.

Mulpuri K, LeBlanc JG, Reilly CW, Poskitt KJ, Choit RL, Sahajpal V, Tredwell SJ (2005) Sternal split approach to the cervicothoracic junction in children. Spine 30:E305–E310. https://doi.org/10.1097/01.brs.0000164267.30422.a9CrossRefPubMed

17.

Obeid I, Taieb A, Vital J-M (2013) Circumferential convex growth arrest by posterior approach for double cervicothoracic curves in congenital scoliosis. Eur Spine J 22:2126–2129. https://doi.org/10.1007/s00586-013-2941-zCrossRefPubMedPubMedCentral

18.

Theologis AA, Gupta MC (2020) The “rail technique” for correction of cervicothoracic kyphosis: case report and surgical technique description. Neurospine 17:652–658. https://doi.org/10.14245/ns.2040390.195CrossRefPubMedPubMedCentral

19.

Shi B-L, Li Y, Zhu Z-Z, Liu W-Y, Liu Z, Sun X, Liu D, Qiu Y (2022) Failed primary surgery in congenital scoliosis caused by a single hemivertebra: reasons and revision strategies. Orthop Surg 14:349–355. https://doi.org/10.1111/os.13198CrossRefPubMed

20.

Smith MD (1994) Congenital scoliosis of the cervical or cervicothoracic spine. Orthop Clin North Am 25:301–310CrossRefPubMed

21.

Liu D, Shi B, Li Y, Liu Z, Sun X, Zhu Z, Qiu Y (2022) Failure of posterior lower lumbar/lumbosacral hemi-vertebra resection: an analysis of reasons and revision strategies. Orthop Surg 14:1413–1419. https://doi.org/10.1111/os.13317CrossRefPubMedPubMedCentral

22.

Shi Z, Li Q, Cai B, Yu B, Feng Y, Wu J, Li M, Ran B (2015) Causes of the failure and the revision methods for congenital scoliosis due to hemivertebra. Congenit Anom (Kyoto) 55:150–154. https://doi.org/10.1111/cga.12107CrossRefPubMed

23.

Yang X, Song Y, Liu L, Zhou C, Zhou Z, Wang L, Wang L (2016) Emerging S-shaped curves in congenital scoliosis after hemivertebra resection and short segmental fusion. Spine J 16:1214–1220. https://doi.org/10.1016/j.spinee.2016.06.006CrossRefPubMed

24.

Yang Y, Yang M, Yang Z, Chen K, Bai J, Zhao J, Ni H, Yang C, Li M (2019) Postoperative neck tilt in Lenke 1 and 2 AIS patients after correction surgery: a novel predictive index. BMC Musculoskelet Disord 20:405. https://doi.org/10.1186/s12891-019-2792-9CrossRefPubMedPubMedCentral

25.

Ruf M, Jensen R, Harms J (2005) Hemivertebra resection in the cervical spine. Spine 30:380–385. https://doi.org/10.1097/01.brs.0000153398.78661.2bCrossRefPubMed

Title: Progressive coronal caudal curve after corrective osteotomies for congenital cervicothoracic scoliosis: incidence and predictors
Authors: Ziqun Liu
Bin Jiang
Yifang Jiang
Yawei Li
Yuliang Dai
Lei Li
Yupeng Zhang
Zhenzhong Zheng
Bing Wang
Publication date: 09-03-2024
Publisher: Springer Berlin Heidelberg
Keyword: Scoliosis
Published in: European Spine Journal / Issue 4/2024
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-024-08189-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Progressive coronal caudal curve after corrective osteotomies for congenital cervicothoracic scoliosis: incidence and predictors

Abstract

Objective

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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