Do Preoperative Supine Radiographs Predict Postoperative Residual Lumbar Curvatures in Adolescent Idiopathic Scoliosis? A Retrospective Cohort Study

Study Design Retrospective comparative study. Objectives This study compares supine vs bending flexibility radiographs and evaluates their ability to predict residual postoperative lumbar curvature after selective thoracic fusion for Lenke 1 and 2 curves across different lumbar modifiers (A, B, and...

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Bibliographic Details
Published in:	Global spine journal Vol. 14; no. 7; pp. 1990 - 1996
Main Authors:	Rajan, Prashant V., Steiner, Richard, Ritzman, Todd F., Moberly, Trey, Floccari, Lorena V.
Format:	Journal Article
Language:	English
Published:	Los Angeles, CA SAGE Publications 01-09-2024 Sage Publications Ltd
Subjects:	Original Scoliosis supine lumbar fusion curve scoliosis predict radiographs
Online Access:	Get full text
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Summary:	Study Design Retrospective comparative study. Objectives This study compares supine vs bending flexibility radiographs and evaluates their ability to predict residual postoperative lumbar curvature after selective thoracic fusion for Lenke 1 and 2 curves across different lumbar modifiers (A, B, and C) in adolescent idiopathic scoliosis (AIS). Methods This was a retrospective review of AIS Lenke 1 and 2 patients who underwent posterior fusion. All patients had preoperative flexibility radiographs including side-bending and supine posteroanterior (PA) films, in addition to pre- and post-operative standing PA and lateral radiographs. We used SurgiMap 2.0 software for all radiographic measurements. Pearson correlations and linear regression models were developed in SAS. Results A total of 86 patients were included mean age 14.9 years and follow-up 72.3 months. Preoperative supine lumbar Cobb angle and preoperative side-bending Cobb angles had similar, positive correlations with postoperative lumbar Cobb angle, r = .55 (P < .001) and r = .54 (P < .001), respectively. Three regression models were built to predict postoperative lumbar Cobb angles from preoperative information: Model S (R2 = .39) uses preoperative supine lumbar curve; Model B (R2 = .44) uses preoperative side-bending lumbar curve; Model SB (R2 = .49) uses both preoperative supine and side-bending lumbar curves. Model S and B performed just as well as Model SB. Conclusion Either supine or side-bending radiographs alone may be used to estimate mean residual postoperative lumbar curvature after selective posterior thoracic fusion, but little is to be gained by taking both supine and side-bending radiographs.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2192-5682 2192-5690
DOI:	10.1177/21925682231162556