Selecting the SSV-1 as LIV in Scheuermann's Kyphosis
- Conditions
- Scheuermann's Kyphosis
- Interventions
- Procedure: Select the vertebra above sagittal stable vertebra as the distal fusion level
- Registration Number
- NCT05953792
- Lead Sponsor
- The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School
- Brief Summary
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.
- Detailed 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.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 74
- 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.
- with previous spinal surgical history;
- with any other spinal deformities;
- without complete follow-up data.
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description thoracic kyphosis Select the vertebra above sagittal stable vertebra as the distal fusion level patients with their kyphotic apex located at T10 or above thoracolumbar kyphosis Select the vertebra above sagittal stable vertebra as the distal fusion level patients with their kyphotic apex located below T10
- Primary Outcome Measures
Name Time Method Sagittal vertical axis (SVA) in millimeters 24 months Measured on anteroposterior and lateral radiographs and defined as the horizontal distance between C7PL and the posterior superior corner of sacrum.
Global kyphosis (GK) in degrees 24 months Measured on anteroposterior and lateral radiographs and defined as the angle from upper to lower most tilted end vertebrae.
Lumbar lordosis (LL) in degrees 24 months Measured on anteroposterior and lateral radiographs and defined as the angle between the the superior end plate of L1 and S1
- Secondary Outcome Measures
Name Time Method Rates of distal junctional kyphosis 24 months record the incidence of the distal junctional kyphosis at the last follow-up. Distal junctional kyphosis was defined as a distal junctional angle ≥10˚, or a distal junctional angle ≥ 10˚ than the preoperative measurement
Scoliosis Research Society (SRS)-22 questionnaire 24 months The Scoliosis Research Society (SRS)-22 questionnaire is adopted to assess the patient-reported outcomes. The overall score can range from 22 to 110 points, and higher scores reflect better health status.
Trial Locations
- Locations (1)
Drum Tower Hospital of Nanjing University Medical School
🇨🇳Nanjing, Jiang Su, China