Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Adolescent Idiopathic Scoliosis Treatment by a Korean Neurosurgeon : The Changing Role for Neurosurgeons

  • Hyun, Seung-Jae (Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Kim, Woong-Beom (Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Park, Young-Seop (Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Kim, Ki-Jeong (Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Jahng, Tae-Ahn (Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Kim, Yongjung J. (Department of Orthopaedic Surgery, Spine Service, Columbia University College of Physicians and Surgeons)
  • Received : 2015.01.08
  • Accepted : 2015.04.20
  • Published : 2015.07.28
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Abstract

Objective : The purpose of this study was to evaluate radiographic/clinical outcomes of adolescent idiopathic scoliosis (AIS) patients treated by a Korean neurosurgeon. Methods : Ten AIS patients were treated by a single neurosurgeon between January 2011 and September 2013 utilizing segmental instrumentation with pedicle screws. Basic demographic information, curve pattern by Lenke classification, number of levels treated, amount of correction achieved, radiographic/clinical outcomes [by Scolisis Resarch Society (SRS-22r) questionnaire] and complications were evaluated to determine the surgical results. Pulmonary function test was utilized to assess forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) before and after surgery. Results : The average percentage of correction of the major structural curve was 73.6% (ranged from 64% to 81.5%). Preoperative and final postoperative absolute FVC averaged 3.03 L and 3.76 L (0.73 L increase, p=0.046), and absolute FEV1 averaged 2.63 L and 3.49 L (0.86 L increase, p=0.021). Preoperative and final postoperative average self-image and function scores of SRS-22r were, $2.6{\pm}0.5$, $3.3{\pm}0.1$, $4.0{\pm}0.5$, and $4.6{\pm}0.0$, respectively. There was a significant improvement of the self-image and function scores of SRS-22r questionnaires before and after surgery (p<0.05). There was no case of neurological deficit, infection and revision for screw malposition. One patient underwent a fusion extension surgery for shoulder asymmetry. Conclusion : Radiographic/clinical outcomes of AIS patients treated by a Korean neurosurgeon were acceptable. Fundamental understanding of pediatric spinal deformity is essential for the practice of AIS surgery.

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References

  1. Ascani E, Bartolozzi P, Logroscino CA, Marchetti PG, Ponte A, Savini R, et al. : Natural history of untreated idiopathic scoliosis after skeletal maturity. Spine (Phila Pa 1976) 11 : 784-789, 1986 https://doi.org/10.1097/00007632-198610000-00007
  2. Asher MA, Min Lai S, Burton DC : Further development and validation of the Scoliosis Research Society (SRS) outcomes instrument. Spine (Phila Pa 1976) 25 : 2381-2386, 2000 https://doi.org/10.1097/00007632-200009150-00018
  3. Faro FD, Marks MC, Pawelek J, Newton PO : Evaluation of a functional position for lateral radiograph acquisition in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 29 : 2284-2289, 2004 https://doi.org/10.1097/01.brs.0000142224.46796.a7
  4. Han IH, Chin DK, Kim KS : Short segment anterior correction of adolescent idiopathic scoliosis. J Korean Neurosurg Soc 44 : 52-56, 2008 https://doi.org/10.3340/jkns.2008.44.1.52
  5. Hyun SJ, Kim YJ, Cheh G, Yoon SH, Rhim SC : Free hand pedicle screw placement in the thoracic spine without any radiographic guidance : technical note, a cadaveric study. J Korean Neurosurg Soc 51 : 66-70, 2012 https://doi.org/10.3340/jkns.2012.51.1.66
  6. Johnson JP, Pashman RS, Lauryssen C, Anand N, Regan JJ, Bray RS : The changing role for neurosurgeons and the treatment of spinal deformity. J Neurosurg Spine 2 : 233-242, 2005 https://doi.org/10.3171/spi.2005.2.3.0233
  7. Kim YJ, Lenke LG, Bridwell KH, Cho YS, Riew KD : Free hand pedicle screw placement in the thoracic spine : is it safe? Spine (Phila Pa 1976) 29 : 333-342; discussion 342, 2004 https://doi.org/10.1097/01.BRS.0000109983.12113.9B
  8. Lee CH, Hyun SJ, Kim YJ, Kim KJ, Jahng TA, Kim HJ : Accuracy of free hand pedicle screw installation in the thoracic and lumbar spine by a young surgeon : an analysis of the first consecutive 306 screws using computed tomography. Asian Spine J 8 : 237-243, 2014 https://doi.org/10.4184/asj.2014.8.3.237
  9. Lenke LG, Betz RR, Harms J, Bridwell KH, Clements DH, Lowe TG, et al. : Adolescent idiopathic scoliosis : a new classification to determine extent of spinal arthrodesis. J Bone Joint Surg Am 83-A : 1169-1181, 2001
  10. Oh CH, Shim YS, Yoon SH, Park HC, Park CO, Lee MS : The psychopathological influence of adolescent idiopathic scoliosis in Korean male : an analysis of multiphasic personal inventory test results. J Korean Neurosurg Soc 53 : 13-18, 2013 https://doi.org/10.3340/jkns.2013.53.1.13
  11. Ovadia D : Classification of adolescent idiopathic scoliosis (AIS). J Child Orthop 7 : 25-28, 2013 https://doi.org/10.1007/s11832-012-0459-2
  12. Panchmatia JR, Isaac A, Muthukumar T, Gibson AJ, Lehovsky J : The 10 key steps for radiographic analysis of adolescent idiopathic scoliosis. Clin Radiol 70 : 235-242, 2015 https://doi.org/10.1016/j.crad.2014.11.013
  13. Risser JC, Norquist DM, Cockrell BR Jr, Tateiwa M, Hoppenfeld S : The effect of posterior spine fusion on the growing spine. Clin Orthop Relat Res 46 : 127-139, 1966
  14. Schlosser TP, Stadhouder A, Schimmel JJ, Lehr AM, van der Heijden GJ, Castelein RM : Reliability and validity of the adapted Dutch version of the revised Scoliosis Research Society 22-item questionnaire. Spine J 14 : 1663-1672, 2014 https://doi.org/10.1016/j.spinee.2013.09.046
  15. Weinstein SL, Dolan LA, Cheng JC, Danielsson A, Morcuende JA : Adolescent idiopathic scoliosis. Lancet 371 : 1527-1537, 2008 https://doi.org/10.1016/S0140-6736(08)60658-3
  16. Weinstein SL, Ponseti IV : Curve progression in idiopathic scoliosis. J Bone Joint Surg Am 65 : 447-455, 1983 https://doi.org/10.2106/00004623-198365040-00004
  17. Wiggins GC, Shaffrey CI, Abel MF, Menezes AH : Pediatric spinal deformities. Neurosurg Focus 14 : e3, 2003
  18. Winter RB, Leonard AS : Surgical correction of congenital thoracic lordosis. J Pediatr Orthop 10 : 805-808, 1990 https://doi.org/10.1097/01241398-199011000-00020