Defining risk factors for adding-on in Lenke 1 and 2 AR curves
Purpose To identify curve/correction characteristics associated with adding-on at 2 years after posterior spinal fusion (PSF) in Lenke 1/2 AR curves. Methods A prospective multicenter registry was queried to identify patients with adolescent idiopathic scoliosis (AIS), Lenke 1/2 AR curves, who under...
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| Veröffentlicht in: | Spine deformity 2021-11, Vol.9 (6), p.1569-1579 |
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| creator | Mitchell, Brendon C. Skaggs, David L. Lenke, Lawrence G. Bastrom, Tracey P. Bartley, Carrie E. Newton, Peter O. |
| description | Purpose
To identify curve/correction characteristics associated with adding-on at 2 years after posterior spinal fusion (PSF) in Lenke 1/2 AR curves.
Methods
A prospective multicenter registry was queried to identify patients with adolescent idiopathic scoliosis (AIS), Lenke 1/2 AR curves, who underwent PSF with a minimum of 2-year follow-up. Patient characteristics as well as pre- and post- operative radiographic variables were evaluated using Classification and Regression Tree (CART) analysis to determine which factors contribute to adding-on.
Results
253 patients treated with PSF were assessed for adding-on, of which 50 met our adding-on criteria. Univariate analysis revealed adding-on was associated several factors including: post-operative thoracic and lumbar curve magnitude (
p
> 0.001), first erect (FE) end instrumented vertebra (EIV) angulation (
p
= 0.009) and EIV translation (
p
= 0.001), younger age (
p
= 0.027), Risser stage (
p
= 0.024), and a more proximal lowest instrumented vertebra (LIV) (
p
0.5°).
Conclusion
In Lenke 1 and 2 AR curves, pre-operative LIV translation appears to be an independent risk factor for adding-on; and in those with |
| doi_str_mv | 10.1007/s43390-021-00382-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2548417680</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2548417680</sourcerecordid><originalsourceid>FETCH-LOGICAL-c275t-c612499b49d951db1db98d25634f44557695ef123759e4a6e8d1c96268b17b613</originalsourceid><addsrcrecordid>eNp9kElLBDEQhYMoOIzzBzzl6CWavZOLMIwrDAii4C2ksww9S3pMpgX_vdEWjxYFVRTvFbwPgHOCLwnGzVXhjGmMMCUIY6YoUkdgQimhiDChjv92_nYKZqWscS2lOFFiAq5vQuxSl1Ywd2UDo3WHPhcY-wyt9_WO-gS7BJchbQIk0CYPKZw_Qzfkj1DOwEm02xJmv3MKXu9uXxYPaPl0_7iYL5GjjTggJwnlWrdcey2Ib2tr5amQjEfOhWikFiESyhqhA7cyKE-cllSqljStJGwKLsa_-9y_D6EczK4rLmy3NoV-KIYKXgM1UuEqpaPU5b6UHKLZ525n86ch2HzzMiMvU3mZH15GVRMbTaWK0ypks-6HnGqk_1xfcNBqCw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2548417680</pqid></control><display><type>article</type><title>Defining risk factors for adding-on in Lenke 1 and 2 AR curves</title><source>SpringerLink Journals - AutoHoldings</source><creator>Mitchell, Brendon C. ; Skaggs, David L. ; Lenke, Lawrence G. ; Bastrom, Tracey P. ; Bartley, Carrie E. ; Newton, Peter O.</creator><creatorcontrib>Mitchell, Brendon C. ; Skaggs, David L. ; Lenke, Lawrence G. ; Bastrom, Tracey P. ; Bartley, Carrie E. ; Newton, Peter O.</creatorcontrib><description>Purpose
To identify curve/correction characteristics associated with adding-on at 2 years after posterior spinal fusion (PSF) in Lenke 1/2 AR curves.
Methods
A prospective multicenter registry was queried to identify patients with adolescent idiopathic scoliosis (AIS), Lenke 1/2 AR curves, who underwent PSF with a minimum of 2-year follow-up. Patient characteristics as well as pre- and post- operative radiographic variables were evaluated using Classification and Regression Tree (CART) analysis to determine which factors contribute to adding-on.
Results
253 patients treated with PSF were assessed for adding-on, of which 50 met our adding-on criteria. Univariate analysis revealed adding-on was associated several factors including: post-operative thoracic and lumbar curve magnitude (
p
> 0.001), first erect (FE) end instrumented vertebra (EIV) angulation (
p
= 0.009) and EIV translation (
p
= 0.001), younger age (
p
= 0.027), Risser stage (
p
= 0.024), and a more proximal lowest instrumented vertebra (LIV) (
p
< 0.001). Multivariate CART analysis showed the chance of adding-on was more than 2 times greater (42 vs 16%) when the chosen LIV was translated more than 2.7 cm from the CSVL. When the LIV was within 2.7 cm, the post-op risk of adding-on was increased when the LIV was not perfectly leveled (> 0.5°).
Conclusion
In Lenke 1 and 2 AR curves, pre-operative LIV translation appears to be an independent risk factor for adding-on; and in those with < 2.7 cm of LIV translation, FE LIV angulation also seems to increase the risk of adding-on. These factors are relevant in determining appropriate LIV selection and aid in identifying patients at risk for developing adding-on.</description><identifier>ISSN: 2212-134X</identifier><identifier>EISSN: 2212-1358</identifier><identifier>DOI: 10.1007/s43390-021-00382-8</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Case Series ; Medicine ; Medicine & Public Health ; Orthopedics</subject><ispartof>Spine deformity, 2021-11, Vol.9 (6), p.1569-1579</ispartof><rights>Scoliosis Research Society 2021</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c275t-c612499b49d951db1db98d25634f44557695ef123759e4a6e8d1c96268b17b613</cites><orcidid>0000-0001-9437-7973</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s43390-021-00382-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s43390-021-00382-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids></links><search><creatorcontrib>Mitchell, Brendon C.</creatorcontrib><creatorcontrib>Skaggs, David L.</creatorcontrib><creatorcontrib>Lenke, Lawrence G.</creatorcontrib><creatorcontrib>Bastrom, Tracey P.</creatorcontrib><creatorcontrib>Bartley, Carrie E.</creatorcontrib><creatorcontrib>Newton, Peter O.</creatorcontrib><title>Defining risk factors for adding-on in Lenke 1 and 2 AR curves</title><title>Spine deformity</title><addtitle>Spine Deform</addtitle><description>Purpose
To identify curve/correction characteristics associated with adding-on at 2 years after posterior spinal fusion (PSF) in Lenke 1/2 AR curves.
Methods
A prospective multicenter registry was queried to identify patients with adolescent idiopathic scoliosis (AIS), Lenke 1/2 AR curves, who underwent PSF with a minimum of 2-year follow-up. Patient characteristics as well as pre- and post- operative radiographic variables were evaluated using Classification and Regression Tree (CART) analysis to determine which factors contribute to adding-on.
Results
253 patients treated with PSF were assessed for adding-on, of which 50 met our adding-on criteria. Univariate analysis revealed adding-on was associated several factors including: post-operative thoracic and lumbar curve magnitude (
p
> 0.001), first erect (FE) end instrumented vertebra (EIV) angulation (
p
= 0.009) and EIV translation (
p
= 0.001), younger age (
p
= 0.027), Risser stage (
p
= 0.024), and a more proximal lowest instrumented vertebra (LIV) (
p
< 0.001). Multivariate CART analysis showed the chance of adding-on was more than 2 times greater (42 vs 16%) when the chosen LIV was translated more than 2.7 cm from the CSVL. When the LIV was within 2.7 cm, the post-op risk of adding-on was increased when the LIV was not perfectly leveled (> 0.5°).
Conclusion
In Lenke 1 and 2 AR curves, pre-operative LIV translation appears to be an independent risk factor for adding-on; and in those with < 2.7 cm of LIV translation, FE LIV angulation also seems to increase the risk of adding-on. These factors are relevant in determining appropriate LIV selection and aid in identifying patients at risk for developing adding-on.</description><subject>Case Series</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopedics</subject><issn>2212-134X</issn><issn>2212-1358</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kElLBDEQhYMoOIzzBzzl6CWavZOLMIwrDAii4C2ksww9S3pMpgX_vdEWjxYFVRTvFbwPgHOCLwnGzVXhjGmMMCUIY6YoUkdgQimhiDChjv92_nYKZqWscS2lOFFiAq5vQuxSl1Ywd2UDo3WHPhcY-wyt9_WO-gS7BJchbQIk0CYPKZw_Qzfkj1DOwEm02xJmv3MKXu9uXxYPaPl0_7iYL5GjjTggJwnlWrdcey2Ib2tr5amQjEfOhWikFiESyhqhA7cyKE-cllSqljStJGwKLsa_-9y_D6EczK4rLmy3NoV-KIYKXgM1UuEqpaPU5b6UHKLZ525n86ch2HzzMiMvU3mZH15GVRMbTaWK0ypks-6HnGqk_1xfcNBqCw</recordid><startdate>20211101</startdate><enddate>20211101</enddate><creator>Mitchell, Brendon C.</creator><creator>Skaggs, David L.</creator><creator>Lenke, Lawrence G.</creator><creator>Bastrom, Tracey P.</creator><creator>Bartley, Carrie E.</creator><creator>Newton, Peter O.</creator><general>Springer International Publishing</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9437-7973</orcidid></search><sort><creationdate>20211101</creationdate><title>Defining risk factors for adding-on in Lenke 1 and 2 AR curves</title><author>Mitchell, Brendon C. ; Skaggs, David L. ; Lenke, Lawrence G. ; Bastrom, Tracey P. ; Bartley, Carrie E. ; Newton, Peter O.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c275t-c612499b49d951db1db98d25634f44557695ef123759e4a6e8d1c96268b17b613</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Case Series</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopedics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mitchell, Brendon C.</creatorcontrib><creatorcontrib>Skaggs, David L.</creatorcontrib><creatorcontrib>Lenke, Lawrence G.</creatorcontrib><creatorcontrib>Bastrom, Tracey P.</creatorcontrib><creatorcontrib>Bartley, Carrie E.</creatorcontrib><creatorcontrib>Newton, Peter O.</creatorcontrib><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Spine deformity</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mitchell, Brendon C.</au><au>Skaggs, David L.</au><au>Lenke, Lawrence G.</au><au>Bastrom, Tracey P.</au><au>Bartley, Carrie E.</au><au>Newton, Peter O.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Defining risk factors for adding-on in Lenke 1 and 2 AR curves</atitle><jtitle>Spine deformity</jtitle><stitle>Spine Deform</stitle><date>2021-11-01</date><risdate>2021</risdate><volume>9</volume><issue>6</issue><spage>1569</spage><epage>1579</epage><pages>1569-1579</pages><issn>2212-134X</issn><eissn>2212-1358</eissn><abstract>Purpose
To identify curve/correction characteristics associated with adding-on at 2 years after posterior spinal fusion (PSF) in Lenke 1/2 AR curves.
Methods
A prospective multicenter registry was queried to identify patients with adolescent idiopathic scoliosis (AIS), Lenke 1/2 AR curves, who underwent PSF with a minimum of 2-year follow-up. Patient characteristics as well as pre- and post- operative radiographic variables were evaluated using Classification and Regression Tree (CART) analysis to determine which factors contribute to adding-on.
Results
253 patients treated with PSF were assessed for adding-on, of which 50 met our adding-on criteria. Univariate analysis revealed adding-on was associated several factors including: post-operative thoracic and lumbar curve magnitude (
p
> 0.001), first erect (FE) end instrumented vertebra (EIV) angulation (
p
= 0.009) and EIV translation (
p
= 0.001), younger age (
p
= 0.027), Risser stage (
p
= 0.024), and a more proximal lowest instrumented vertebra (LIV) (
p
< 0.001). Multivariate CART analysis showed the chance of adding-on was more than 2 times greater (42 vs 16%) when the chosen LIV was translated more than 2.7 cm from the CSVL. When the LIV was within 2.7 cm, the post-op risk of adding-on was increased when the LIV was not perfectly leveled (> 0.5°).
Conclusion
In Lenke 1 and 2 AR curves, pre-operative LIV translation appears to be an independent risk factor for adding-on; and in those with < 2.7 cm of LIV translation, FE LIV angulation also seems to increase the risk of adding-on. These factors are relevant in determining appropriate LIV selection and aid in identifying patients at risk for developing adding-on.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><doi>10.1007/s43390-021-00382-8</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-9437-7973</orcidid></addata></record> |
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| ispartof | Spine deformity, 2021-11, Vol.9 (6), p.1569-1579 |
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| language | eng |
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| source | SpringerLink Journals - AutoHoldings |
| subjects | Case Series Medicine Medicine & Public Health Orthopedics |
| title | Defining risk factors for adding-on in Lenke 1 and 2 AR curves |
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