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STUDY DESIGN.: Retrospective analysis. OBJECTIVE.: To evaluate movement of the aorta in patients with scoliosis who have undergone the posterior correction and fusion. SUMMARY OF BACKGROUND DATA.: Surgeons check preoperative imaging for pedicle screw placement, but past analyses indicated that the aorta shifts after scoliosis surgery. Few studies, however, evaluated the aorta movement in detail. METHODS.: A total of 22 patients with a right thoracic curve underwent posterior instrumentation and fusion. The average age at surgery was 17.2 years. The average of the preoperative Cobb angle was 65.2 degrees which decreased to 20.0 degrees .Computed-tomographic data were analyzed by multiplanar reconstruction. In our coordinate system, the middle of the base of the left superior facet was set as the origin and a line connecting the middle points of both bases of the superior facets was defined as the X-axis. We defined the angle and the distance to describe the aorta position and analyzed the movement of the aorta relative to the spine. Deformity parameters were examined to determine their correlation with the aorta parameters.We simulated variable pedicle screw placement and defined a warning pedicle when the aorta enters the expected area of the screw and examined them in 24 scenarios. RESULTS.: The aorta moved 4.7 +/- 3.0 mm on an average. The aorta had a tendency to migrate in the anteromedial direction and this movement correlated with preoperative apical vertebral translation, preoperative sagittal alignment, and change of sagittal alignment. The ratio of warning pedicles at the middle thoracic level (T7-T9) increased after deformity correction. CONCLUSION.: The aorta moved anteromedially relative to the spine after the posterior correction and the risk of the aorta by a pedicle screw increased by correction of the deformity at the middle thoracic spine. Surgeons are recommended to anticipate the aorta movement in the surgical planning.
From the *Department of Orthopaedic Surgery, the University of Tokyo, Tokyo, Japan; and the daggerDepartment of Orthopaedic Surgery, the Saitama Medical Center, Saitama, Japan.
This article was published in the following journal.
This study reports the recent experience in the management of scoliosis in Down's syndrome. Curve patterns, progression in brace, and surgical outcomes were recorded. Cardiac surgery history was compa...
Prospective clinical study OBJECTIVE.: To analyze the amount blood loss at different stages of Posterior Instrumented Spinal Fusion (PSF) surgery in AIS patients.
OBJECTIVE There have been no reports on the long-term radiographic outcomes of posterior vertebral column resection (PVCR) in patients with congenital scoliosis. The purpose of this study was to evalu...
Children with Medicaid may have difficulty accessing care for adolescent idiopathic scoliosis (AIS), a condition that may worsen with time. We conducted a study to determine whether patients with Medi...
Radiographic analysis with scoliosis patients.
The purpose of this study is to find out the outcomes of using the PASS LP System to correct adolescent idiopathic scoliosis. This system is a unique set of spinal instrumentation used to ...
This study will explore the relationship between skeletal muscle and physical activity in scoliosis patients to provide insight into both the etiology of scoliosis and potential ways to mi...
Although practiced for many years, surgical correction of scoliosis is relatively subject published for idiopathic scoliosis and a few published for other types of scoliosis. This study i...
Investigation of tranexamic acid (TXA) for reducing perioperative blood loss and transfusion requirement in pediatric patients with secondary scoliosis undergoing posterior spinal fusion.
This research is being done to compare two methods of surgery to treat scoliosis and/or kyphosis of the spine.
The portion of the descending aorta proceeding from the arch of the aorta and extending to the DIAPHRAGM, eventually connecting to the ABDOMINAL AORTA.
Surgery which could be postponed or not done at all without danger to the patient. Elective surgery includes procedures to correct non-life-threatening medical problems as well as to alleviate conditions causing psychological stress or other potential risk to patients, e.g., cosmetic or contraceptive surgery.
Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.
Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure.
A condition of persistent pain and discomfort in the BACK and the LEG following lumbar surgery, often seen in patients enrolled in pain centers.
Arthritis Fibromyalgia Gout Lupus Rheumatic Rheumatology is the medical specialty concerned with the diagnosis and management of disease involving joints, tendons, muscles, ligaments and associated structures (Oxford Medical Diction...