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Revista de la Asociación Argentina de Ortopedia y Traumatología
On-line version ISSN 1852-7434
Abstract
PUIGDEVALL, Miguel et al. Cambios en la lordosis lumbar luego de una artrodesis vertebral posterior de la columna torácica y su relación con la incidencia pelviana. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2016, vol.81, n.2, pp.122-127. ISSN 1852-7434.
Objective: To evaluate the sagittal profile variables in patients with adolescent idiopathic scoliosis who underwent selective thoracic posterior spinal instrumentation and fusion with pedicle screws and to determine relationships among them. Methods: Twenty consecutive patients were retrospectively evaluated. Changes in cervical lordosis, thoracic kyphosis, proximal junctional kyphosis, lumbar lordosis, pelvic incidence and global sagittal balance were compared in standing lateral radiographs performed before surgery, at the immediate postoperative period, and two years after surgery. Changes in postoperative lumbar lordosis were correlated with changes in thoracic kyphosis and pelvic incidence. Results: There was a significant decrease in thoracic kyphosis and lumbar lordosis between preoperative and immediate postoperative radiographs, but both parameters showed an increase in the radiographs two years later. A significant increase in proximal junctional kyphosis and cervical lordosis was also found between preoperative and 2-year postoperative radiographs. The only significant postoperative correlation found was between lumbar lordosis and pelvic incidence at 2-year follow-up control. Conclusions: Posterior spinal instrumentation and fusion with pedicle screws in Lenke type 1 deformities reduces thoracic kyphosis and lumbar lordosis, and increases cervical lordosis and proximal junctional kyphosis. Uninstrumented lumbar lordosis increased at 2-year follow-up and it is strongly related to the pelvic incidence.
Keywords : Lumbar lordosis; Posterior spinal fusion; Adolescent idiopathic scoliosis; Pedicle screws.