ArticleSpine deformity2025
Improving shoulder balance in lenke type 2 and 4 adolescent idiopathic scoliosis: clinical advantages of a proximal thoracic concave rod technique.
Article in Spine deformity, 2025. 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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Abstract
purposeTo evaluate a novel proximal thoracic concave rod (PTCR) technique for improving postoperative shoulder imbalance (SI) in adolescent idiopathic scoliosis (AIS) patients with Lenke types 2 and 4 curves, compared to conventional methods.
methodsA retrospective study of 30 AIS patients (10 with PTCR, 20 without) from a multicentric European database was conducted. Patients aged ≤ 18 years undergoing surgery for Lenke types 2 or 4 curves with ≥ 2 years of follow-up were included. Radiographic parameters, including Clavicle Angle (CA) and T1 Coronal Tilt (T1CT), were assessed preoperatively, immediately postoperatively, and at 2 years. Demographic, surgical, radiological parameters, and patient-reported outcomes measures (PROMs) were compared between groups.
resultsPTCR significantly improved SI, achieving optimal CA in 80% of cases versus 35% in the non-PTCR group (p = 0.02). CA correction was superior in the PTCR group (-1.66° ± 1.34° vs. 1.06 ± 2.59°, p < 0.001). While T1CT correction showed greater improvement in the PTCR group (-3.62° ± 5.56° vs. -0.31° ± 8.13°) it was not statistically significant (p = 0.258). PTCR did not increase surgical time, blood loss, or complications.
conclusionsPTCR is a promising approach for managing shoulder imbalance in AIS patients with Lenke types 2 or 4 curves. Larger prospective studies are necessary to validate these findings. LEVEL OF EVIDENCE: Level of Evidence: III.
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