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Treatment of the Fractional Curve of Adult Scoliosis With Circumferential Minimally Invasive Surgery Versus Traditional, Open Surgery: An Analysis of Surgical Outcomes.

Publication ,  Journal Article
Chou, D; Mummaneni, P; Anand, N; Nunley, P; La Marca, F; Fu, K-M; Fessler, R; Park, P; Wang, M; Than, K; Nguyen, S; Uribe, J; Zavatsky, J ...
Published in: Global Spine J
December 2018

STUDY DESIGN: Retrospective, multicenter review of adult scoliosis patients with minimum 2-year follow-up. OBJECTIVE: Because the fractional curve (FC) of adult scoliosis can cause radiculopathy, we evaluated patients treated with either circumferential minimally invasive surgery (cMIS) or open surgery. METHODS: A multicenter retrospective adult deformity review was performed. Patients included: age >18 years with FC >10°, ≥3 levels of instrumentation, 2-year follow-up, and one of the following: coronal Cobb angle (CCA) > 20°, pelvic incidence and lumbar lordosis (PI-LL) > 10°, pelvic tilt (PT) > 20°, and sagittal vertical axis (SVA) > 5 cm. RESULTS: The FC was treated in 118 patients, 79 open and 39 cMIS. The FCs had similar coronal Cobb angles preoperative (17° cMIS, 19.6° open) and postoperative (7° cMIS, 8.1° open), but open had more levels treated (12.1 vs 5.7). cMIS patients had greater reduction in VAS leg (6.4 to 1.8) than open (4.3 to 2.5). With propensity matching 40 patients for levels treated (cMIS: 6.6 levels, N = 20; open: 7.3 levels, N = 20), both groups had similar FC correction (18° in both preoperative, 6.9° in cMIS and 8.5° postoperative). Open had more posterior decompressions (80% vs 22.2%, P < .001). Both groups had similar preoperative (Visual Analogue Scale [VAS] leg 6.1 cMIS and 5.4 open) and postoperative (VAS leg 1.6 cMIS and 3.1 open) leg pain. All cMIS patients had interbody grafts; 35% of open did. There was no difference in change of primary CCA, PI-LL, LL, Oswestry Disability Index, or VAS Back. CONCLUSION: Patients' FCs treated with cMIS had comparable reduction of leg pain compared with those treated with open surgery, despite significantly fewer cMIS patients undergoing direct decompression.

Duke Scholars

Published In

Global Spine J

DOI

ISSN

2192-5682

Publication Date

December 2018

Volume

8

Issue

8

Start / End Page

827 / 833

Location

England

Related Subject Headings

  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Chou, D., Mummaneni, P., Anand, N., Nunley, P., La Marca, F., Fu, K.-M., … International Spine Study Group, . (2018). Treatment of the Fractional Curve of Adult Scoliosis With Circumferential Minimally Invasive Surgery Versus Traditional, Open Surgery: An Analysis of Surgical Outcomes. Global Spine J, 8(8), 827–833. https://doi.org/10.1177/2192568218775069
Chou, Dean, Praveen Mummaneni, Neel Anand, Pierce Nunley, Frank La Marca, Kai-Ming Fu, Richard Fessler, et al. “Treatment of the Fractional Curve of Adult Scoliosis With Circumferential Minimally Invasive Surgery Versus Traditional, Open Surgery: An Analysis of Surgical Outcomes.Global Spine J 8, no. 8 (December 2018): 827–33. https://doi.org/10.1177/2192568218775069.
Chou, Dean, et al. “Treatment of the Fractional Curve of Adult Scoliosis With Circumferential Minimally Invasive Surgery Versus Traditional, Open Surgery: An Analysis of Surgical Outcomes.Global Spine J, vol. 8, no. 8, Dec. 2018, pp. 827–33. Pubmed, doi:10.1177/2192568218775069.
Chou D, Mummaneni P, Anand N, Nunley P, La Marca F, Fu K-M, Fessler R, Park P, Wang M, Than K, Nguyen S, Uribe J, Zavatsky J, Deviren V, Kanter A, Okonkwo D, Eastlack R, Mundis G, International Spine Study Group. Treatment of the Fractional Curve of Adult Scoliosis With Circumferential Minimally Invasive Surgery Versus Traditional, Open Surgery: An Analysis of Surgical Outcomes. Global Spine J. 2018 Dec;8(8):827–833.
Journal cover image

Published In

Global Spine J

DOI

ISSN

2192-5682

Publication Date

December 2018

Volume

8

Issue

8

Start / End Page

827 / 833

Location

England

Related Subject Headings

  • 3202 Clinical sciences