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Adding-on Phenomenon After Surgery in Lenke Type 1, 2 Adolescent Idiopathic Scoliosis: Is it Predictable?

Abstract：

STUDY DESIGN:A retrospective study. OBJECTIVE:The aim of this study was to detect risk factors for Adding-on after posterior correction surgery in patients with Lenke 1 or 2 AIS, and to explore whether Adding-on Index could be used to predict Adding-on effectively. SUMMARY OF BACKGROUND DATA:Adding-on phenomenon is a common complication in Lenke 1 or 2 AIS patients after correction surgery. However, whether it can be predicted after surgery remains unknown. METHODS:Lenke 1 or 2 AIS patients receiving correction surgery in our center from January 2009 to July 2013 were analyzed. Antero-posterior and lateral films were evaluated before surgery, at 2 weeks' and 2 years' follow-up. Patients were divided into 2 groups according to whether Adding-on occurred at the 2 years' follow-up. Risk factors of Adding-on were analyzed, and Adding-on Index was proposed and verified. RESULTS:Sixteen patients (16.3%) suffered from distal Adding-on at 2-year follow-up. Several parameters were found to be significantly different between 2 groups, including Risser's sign, postoperative Cobb angle of main thoracic, postoperative Cobb angle of main thoracic curve at 2-year follow-up, preoperative and postoperative Cobb angle of lumbar curve, postoperative Cobb angle of lumbar curve at 2-year follow-up, LIV-EV, LIV-SV, LIV-CSVL, LAV-CSVL, LAV-LIV, DnfS, and postoperative TJK. No significant differences in SRS-22 scores were observed. Binary logistic regression analysis showed that DnfS and postoperative residual Cobb angle of lumbar curve were primary factors for occurrence of Adding-on. According to the regression equation, Adding-on Index was defined as 4 × DnfS-postoperative lumbar curves Cobb angle. On the basis of ROC curve, if Adding-on Index was more than 12, the occurrence rate of Adding-on was 88%. On the contrary, the rate of no Adding-on phenomenon was 80%. CONCLUSION:DnfS and posterior Cobb angle of lumbar curve were 2 important factors for Adding-on in Lenke 1, 2 AIS patients. Adding-on Index can be used to predict the occurrence of Adding-on effectively. LEVEL OF EVIDENCE:4.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Yang C,Li Y,Yang M,Zhao Y,Zhu X,Li M,Liu G

doi

10.1097/BRS.0000000000001303

subject

Has Abstract

pub_date

2016-04-01 00:00:00

pages

698-704

issue

eissn

0362-2436

issn

1528-1159

journal_volume

pub_type

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Adding-on Phenomenon After Surgery in Lenke Type 1, 2 Adolescent Idiopathic Scoliosis: Is it Predictable?