Selecting the SSV-1 as LIV in Scheuermann's Kyphosis

Nanjing University

Status: Completed

Conditions: Scheuermann's Kyphosis

Treatments: Procedure: Select the vertebra above sagittal stable vertebra as the distal fusion level

Study type: Observational

Funder types: Other

Identifiers

NCT05953792

2021-LCYJ-DBZ-05

Details and patient eligibility

About

The proper selection of the lowest instrumented vertebra (LIV) remains controversial in the surgical treatment of Scheuermann's disease and there is a paucity of studies investigating the clinical outcomes of fusion surgery when selecting the vertebra one level proximal to the sagittal stable vertebra (SSV-1) as LIV. The purpose of this study is to investigate whether SSV-1 could be a valid LIV for Scheuermann kyphosis (SK) patients with different curve patterns.

Full description

The proper selection of the lowest instrumented vertebra (LIV) remains controversial in the surgical treatment of Scheuermann's disease and there is a paucity of studies investigating the clinical outcomes of fusion surgery when selecting the vertebra one level proximal to the sagittal stable vertebra (SSV-1) as LIV. The purpose of this study is to investigate whether SSV-1 could be a valid LIV for Scheuermann kyphosis (SK) patients with different curve patterns.

This was a prospective study on consecutive SK patients treated with posterior surgery between January 2018 and September 2020, in which the distal fusion level ended at SSV-1. The LIV was selected at SSV-1 only in patients with Risser > 2 and with LIV translation less than 40mm. All of the patients had a minimum of 2-year follow-up. Patients were further grouped based on the sagittal curve pattern as thoracic kyphosis (TK) and thoracolumbar kyphosis (TLK). Radiographic parameters including global kyphosis (GK), lumbar lordosis (LL), sagittal vertical axis (SVA), LIV translation, pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS) were measured preoperatively, postoperatively and at the latest follow-up. The intraoperative and postoperative complications were recorded. The Scoliosis Research Society (SRS)-22 scores were performed to evaluate clinical outcomes.

Enrollment: 74 patients

Sex: All

Ages: 10 to 20 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• diagnosis of SK patients;
• underwent one-stage posterior spinal fusion (PSF) with multi-level Ponte osteotomies;
• selecting SSV-1 as LIV;
• with a minimum follow-up of 2 years.

Exclusion criteria

• with previous spinal surgical history;
• with any other spinal deformities;
• without complete follow-up data.

Trial design

74 participants in 2 patient groups

thoracic kyphosis

Description:

patients with their kyphotic apex located at T10 or above

Treatment:

Procedure: Select the vertebra above sagittal stable vertebra as the distal fusion level

thoracolumbar kyphosis

Description:

patients with their kyphotic apex located below T10

Treatment:

Procedure: Select the vertebra above sagittal stable vertebra as the distal fusion level