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ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2020

The rotation of preoperative-presumed lowest instrumented vertebra: Is it a risk factor for distal adding-on in Lenke 1A/2A curve treated with selective thoracic fusion?

Zhong He, Xiaodong Qin, Rui Yin, Zhen Liu, Bangping Qian, Yong Qiu, Zezhang Zhu

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Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
  4. A mathematical model for estimating the intraoperative lowest instrumented vertebra (LIV) tilt angle using preoperative supine left side-bending (LSB) radiographs in adolescent idiopathic scoliosis (AIS) patients with lenke type 1 and 2 non-AR curves.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025
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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Zhong He *Department of Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China.
Xiaodong Qin *Department of Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China.
Rui YinDepartment of Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China.
Zhen LiuDepartment of Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China.
Bangping QianDepartment of Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China.
Yong QiuDepartment of Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China.
Zezhang ZhuDepartment of Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China. zhuzezhang@126.com.ORCID http://orcid.org/0000-0002-6411-4619

Funding

Fundamental Research Funds for the Central Universities YG1805007Jiangsu Province 333 Talent Grant 2016-III-0114Jiangsu Provincial Key Medical Center YXZXA2016009
6 · The paper itself

Abstract

purposeTo investigate whether the rotation of preoperative-presumed lowest instrumented vertebra (LIV) is a risk factor for adding-on (AO) in adolescent idiopathic scoliosis (AIS) treated with selective posterior thoracic fusion (sPTF).

methodsA total of 196 AIS patients of Lenke type 1A or 2A with minimum 2-year follow-up after sPTF with all pedicle screw instrumentation were included. Radiographical parameters were measured as follows: preoperative rotation angle of presumed LIV and LIV + 1, LIV + 1/LIV rotation difference, postoperative rotation angle of LIV and LIV derotation angle on CT scans. Patients were classified into AO group and non-AO group during the follow-up. The parameters were compared between the two groups to investigate risk factors for AO.

resultsAmong 196 patients, 40 (20.4%) patients developed with AO at the final follow-up. Compared with non-AO group, patients with AO had significantly larger preoperative rotation angle of presumed LIV (8.8° ± 3.4° vs. 3.4° ± 2.9°, P < 0.001) and LIV + 1 (5.9° ± 4.0° vs. 3.6° ± 2.9°, P = 0.004), LIV + 1/LIV rotation difference (- 2.6° ± 3.7° vs. 0.6° ± 3.2°, P < 0.001) and postoperative rotation angle of LIV (7.2° ± 4.3° vs. 3.0° ± 2.9°, P < 0.001). The last substantially touched vertebrae (LSTV) was selected as LIV in 148 patients, among which the above described parameters were found to be remarkably larger in AO group than non-AO group as well. Multivariate analysis presented Risser grade and preoperative rotation angle of presumed LIV as independent predictors of AO.

conclusionAIS patients with low Risser grade and large preoperative rotation angle of presumed LIV are more likely to develop with AO after sPTF. Moreover, for the patients with LSTV selected as LIV, preoperative rotation of presumed LIV might be still a risk factor associated with the occurrence of AO. LEVEL OF EVIDENCE: III These slides can be retrieved under Electronic Supplementary Material.

Indexed as

ScoliosisSpinal FusionAdolescentHumansLumbar VertebraeRetrospective StudiesRisk FactorsRotationThoracic VertebraeTreatment OutcomeAdding-onAdolescent idiopathic scoliosisLast touching vertebraLowest instrumented vertebraVertebral rotation

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.