Factors associated with postoperative coronal imbalance in adult patients with severe and rigid scoliosis: a retrospective study.

Publisher: BioMed Central Country of Publication: England NLM ID: 101265112 Publication Model: Electronic Cited Medium: Internet ISSN: 1749-799X (Electronic) Linking ISSN: 1749799X NLM ISO Abbreviation: J Orthop Surg Res Subsets: MEDLINE

Original Publication: London : BioMed Central, 2006-

Scoliosis*/surgery ; Scoliosis*/diagnostic imaging ; Postoperative Complications*/etiology ; Postoperative Complications*/diagnostic imaging ; Postoperative Complications*/epidemiology ; Osteotomy*/methods ; Spinal Fusion*/methods ; Spinal Fusion*/adverse effects; Humans ; Retrospective Studies ; Female ; Male ; Adult ; Middle Aged ; Severity of Illness Index ; Nomograms ; Risk Factors ; Follow-Up Studies ; Young Adult ; Treatment Outcome ; Aged

Background: Extensive studies examined coronal imbalance (CIB) in adolescent and adult degenerative scoliosis; however, few studies addresses on CIB in adult with severe rigid scoliosis (SRS). Therefore, we analyzed postoperative SRS patients to identify factors associated with postoperative CIB.
Methods: In this retrospective study, we investigated SRS patients undergoing one-stage posterior column osteotomy (PCO) and fusion at our hospital between August 2012 and January 2019. The preoperative, postoperative and follow-up whole-spine anteroposterior (AP) radiographs were evaluated. Potential risk factors for postoperative CIB were analyzed using the LASSO regression, and independent risk factors were identified using binary logistic regression. A nomogram prediction model was constructed and validated.
Results: Ninety eligible SRS patients were included. Postoperative radiographs showed a main curve correction rate of 54.17 ± 14.02%; however, follow-up CIB persisted in 26.67% of patients. Three independent variables affecting follow-up CIB were identified by LASSO regression, including preoperative CIB+ [OR = 12.414 (95% CI: 2.228, 69.162), P = 0.004], major curve flexibility index < 10% [OR = 14.300 (95% CI: 2.200, 92.957), P = 0.005], and immediate postoperative CIB [OR = 5.169 (95% CI: 1.387, 19.263), P = 0.014]. ROC and DCA analysis demonstrated that the nomogram had good predictive performance.
Conclusions: Preoperative CIB+, major curve flexibility index < 10%, and immediate postoperative CIB were significantly associated with postoperative CIB. These findings offer valuable guidance to improve surgical outcomes and reduce complications.
Competing Interests: Declarations. Ethics approval and consent to participate: The research conducted has been performed in accordance with the Declaration of Helsinki. Approval for the study was obtained from the ethics committees of the Beijing Chaoyang Hospital (LGH-2023-FEI-93). Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.
(© 2024. The Author(s).)

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CYFH202218 Clinical Research Incubation Project, Beijing Chaoyang Hospital, Capital Medical University

Keywords: Coronal balance; Nomogram prediction model; Radiographic parameters; Severe and rigid scoliosis

Date Created: 20241219 Date Completed: 20241219 Latest Revision: 20241219

20241219

10.1186/s13018-024-05328-0

39695819