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- Title
Shoulder balance in Lenke type 2 adolescent idiopathic scoliosis: correlations among radiological indices, cosmetic indices, and patient-reported outcomes.
- Authors
Hyung Rae Lee; Chang Ju Hwang; Sang Yun Seok; Geon Jung Kim; Jae Hwan Cho; Dong-Ho Lee; Choon Sung Lee
- Abstract
OBJECTIVE The aim of this study was to investigate the correlation between radiological indices of shoulder balance (SB) and cosmetic indices of shoulder deformity in patients with Lenke type 2 adolescent idiopathic scoliosis (AIS) and to determine the extent to which patient-reported outcomes (PROs) correlate with these measurements. Current management decisions and outcomes for SB in AIS are primarily based on radiological measurements. It is crucial to understand how these radiological parameters and cosmetic indices relate to patient satisfaction. METHODS The authors analyzed the preoperative radiological and photographic indices of SB, along with PROs, in patients with Lenke type 2 AIS. Lateral SB parameters included the radiological shoulder height (RSH) and clavicle angle, while medial SB parameters included the first rib angle and T1 tilt angle. Photographic indices included the shoulder height angle (SHA), axilla height angle (AHA), and the left/right trapezius angle (LRTA) ratio. The authors assessed the self-image, mental health, and total score domains of the Korean version of the 22-item Scoliosis Research Society questionnaire. RESULTS In their analysis of Lenke type 2 patients, the authors found that correlation coefficients between radiological measurements and photographic indices ranged from -0.25 to 0.47, among which only lateral SB including clavicle angle and RSH showed a significant correlation with anterior and posterior photographic indices. No statistically significant correlations were found between radiological measurements and PROs. Anterior photographic indices including SHA and AHA significantly correlated with all three PROs (p < 0.05). CONCLUSIONS Radiological shoulder parameters did not accurately reflect the perceived SB. Anterior photographic indices were reliable for evaluating clinical SB in patients with Lenke type 2 AIS and correlated with PROs. Spine surgeons may benefit from paying more attention to anterior photographic indices when making surgical decisions regarding clinical SB.
- Publication
Journal of Neurosurgery: Spine, 2024, Vol 40, Issue 6, p700
- ISSN
1547-5654
- Publication type
Article
- DOI
10.3171/2024.1.SPINE231010