Can postoperative Cobb and pelvic obliquity corrections be predicted using supine traction X-rays in non-ambulatory patients with cerebral palsy fused to L5? A case series study.

Ruben Alejandro Morales Ciancio, Jonathan Lucas, Stewart Tucker, Thomas Ember, Mark Harris, Edel Broomfield

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Article in Spine deformity, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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Ruben Alejandro Morales CiancioOrthopaedic and Spine Department, Great Ormond Street Hospital, Great Ormond Street, London, WC1N 3JH, UK. ale.moralesc@gmail.com.ORCID 0000-0001-6696-5989

Jonathan LucasPaediatric Spine Department, Evelina London Children Hospital, London, UK.

Stewart TuckerOrthopaedic and Spine Department, Great Ormond Street Hospital, Great Ormond Street, London, WC1N 3JH, UK.

Thomas EmberOrthopaedic and Spine Department, Great Ormond Street Hospital, Great Ormond Street, London, WC1N 3JH, UK.

Mark HarrisOrthopaedic and Spine Department, Great Ormond Street Hospital, Great Ormond Street, London, WC1N 3JH, UK.

Edel BroomfieldOrthopaedic and Spine Department, Great Ormond Street Hospital, Great Ormond Street, London, WC1N 3JH, UK.

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6 · The paper itself

Abstract

purposeThis study aimed to determine whether Cobb and pelvic obliquity corrections can be predicted using supine traction radiographs in patients with cerebral palsy (CP) who underwent posterior spinal fusion (PSF) from T2/3 to L5.

methodsFrom January 2010 to January 2020, 167 non-ambulatory patients with CP scoliosis underwent PSF using pedicle screws in two quaternary centers with a minimum of 2 years follow-up (FU). Radiological measurements and chart reviews were performed.

resultsA total of 106 patients aged 15.6 ± 0.4 years were included. All patients had significant correction of the Cobb angle (MC), pelvic obliquity (PO), thoracic kyphosis (TK), and lumbar lordosis (LL) without loss of correction at the last FU (LFU). Curve flexibility was significantly correlated with Cobb correction (δMC) immediately postoperatively (p < 0.0001, r = 0.8950), followed by the amount of correction in pelvic obliquity under traction (δPOT) (p = 0.0252, r = 0.2174). For correction in PO (δPO), the most significant variable was δPOT (p < 0.0001, r = 0.7553), followed by curve flexibility (p = 0.0059, r = 0.26) and the amount of correction in Cobb under traction (p = 0.0252, r = 0.2174).

conclusionsCobb and PO corrections can be predicted using supine traction films for non-ambulatory CP patients treated with PSF from T2/3 to L5. The variables evaluated were interconnected, reinforcing preoperative planning for these patients. Comparative large-scale studies on patient-related clinical outcomes are required to determine whether this predicted correction is associated with improved surgical outcomes and reduced complication rates. LEVEL OF EVIDENCE: IV.

Indexed as

Cerebral PalsyLumbar VertebraeScoliosisSpinal FusionTractionAdolescentFemaleHumansKyphosisLordosisMalePelvisPostoperative PeriodRadiographyRetrospective StudiesSupine PositionCerebral palsyNeuromuscular scoliosisNon-ambulatoryPelvic obliquity correctionScoliosis surgery

Identifiers

PMID38683285

DOI10.2106/JBJS.OA.22.00123

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