TY - JOUR
T1 - Sagittal plane deformities in children with sma2 following posterior spinal instrumentation
AU - Halanski, Matthew A.
AU - Hanna, Rewais
AU - Bernatz, James
AU - Twedt, Max
AU - Sund, Sarah
AU - Patterson, Karen
AU - Noonan, Kenneth J.
AU - Schultz, Meredith
AU - Schroth, Mary K.
AU - Sharafinski, Mark
AU - Hasley, Brian P.
N1 - Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021/8
Y1 - 2021/8
N2 - This is a retrospective radiographic review to assess post-operative sagittal plane deformities in patients with Spinal Muscular Atrophy type 2 that had been treated with posterior spinal instrumentation. Thirty-two patients with a history of either spinal fusion (N = 20) or growing rods (N = 12) were identified with an average of 7.6 (2.1–16.6) years post-operative follow-up. Forty percent (13/32) of the patients were identified as having obvious “tucked chin” (N = 4), “tipped trunk” (N = 9), or both (N = 3). Sacral incidence was the only parameter that was statistically significant change between pre-operative or immediate post-operative measurements (66.9◦ vs. 55.2◦ p = 0.03). However, at final follow-up, the post-operative thoracic kyphosis had decreased over time in those that developed a subsequent sagittal deformity (24.2◦ ) whereas it increased in those that did not (44.7◦, p = 0.008). This decrease in thoracic kyphosis throughout the instrumented levels, resulted in a greater lordotic imbalance (30.4◦ vs. 5.6◦, p = 0.001) throughout the instrumented levels in the group that developed the subsequent cervical or pelvic sagittal deformities. In conclusion, sagittal plane deformities commonly develop outside the instrumented levels in children with SMA type 2 following posterior spinal instrumentation and may be the result of lordotic imbalance that occurs through continued anterior growth following posterior instrumentation.
AB - This is a retrospective radiographic review to assess post-operative sagittal plane deformities in patients with Spinal Muscular Atrophy type 2 that had been treated with posterior spinal instrumentation. Thirty-two patients with a history of either spinal fusion (N = 20) or growing rods (N = 12) were identified with an average of 7.6 (2.1–16.6) years post-operative follow-up. Forty percent (13/32) of the patients were identified as having obvious “tucked chin” (N = 4), “tipped trunk” (N = 9), or both (N = 3). Sacral incidence was the only parameter that was statistically significant change between pre-operative or immediate post-operative measurements (66.9◦ vs. 55.2◦ p = 0.03). However, at final follow-up, the post-operative thoracic kyphosis had decreased over time in those that developed a subsequent sagittal deformity (24.2◦ ) whereas it increased in those that did not (44.7◦, p = 0.008). This decrease in thoracic kyphosis throughout the instrumented levels, resulted in a greater lordotic imbalance (30.4◦ vs. 5.6◦, p = 0.001) throughout the instrumented levels in the group that developed the subsequent cervical or pelvic sagittal deformities. In conclusion, sagittal plane deformities commonly develop outside the instrumented levels in children with SMA type 2 following posterior spinal instrumentation and may be the result of lordotic imbalance that occurs through continued anterior growth following posterior instrumentation.
KW - Kyphosis
KW - Posterior spinal fusion
KW - Sagittal plane deformity
KW - Spinal muscular atrophy
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U2 - 10.3390/children8080703
DO - 10.3390/children8080703
M3 - Article
C2 - 34438594
AN - SCOPUS:85114235585
SN - 2227-9067
VL - 8
JO - Children
JF - Children
IS - 8
M1 - 703
ER -