Optimal surgical care for adolescent idiopathic scoliosis: an international consensus

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• 作者：Marinus de Kleuver (1)
  Stephen J. Lewis (2)
  Niccole M. Germscheid (3)
  Steven J. Kamper (4)
  Ahmet Alanay (5)
  Sigurd H. Berven (6)
  Kenneth M. Cheung (7)
  Manabu Ito (8)
  Lawrence G. Lenke (9)
  David W. Polly (10)
  Yong Qiu (11)
  Maurits van Tulder (12)
  Christopher Shaffrey (13)
  
• 关键词：Adolescent idiopathic scoliosis ; Surgery ; Optimal care ; Delphi ; Consensus
• 刊名：European Spine Journal
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：23
• 期：12
• 页码：2603-2618
• 全文大小：626 KB
• 参考文献：1. Fischer CR, Kim Y (2011) Selective fusion for adolescent idiopathic scoliosis: a review of current operative strategy. Eur Spine J 20(7):1048-057. doi:10.1007/s00586-011-1730-9 CrossRef
  2. Roach JW, Mehlman CT, Sanders JO (2011) Does the outcome of adolescent idiopathic scoliosis surgery justify the rising cost of the procedures? J Pediatr Orthop 31(1 Suppl):S77–S80. doi:10.1097/BPO.0b013e3181f73bfd CrossRef
  3. Daffner SD, Beimesch CF, Wang JC (2010) Geographic and demographic variability of cost and surgical treatment of idiopathic scoliosis. Spine (Phila Pa 1976) 35(11):1165-169. doi:10.1097/BRS.0b013e3181d88e78
  4. Aubin CE, Labelle H, Ciolofan OC (2007) Variability of spinal instrumentation configurations in adolescent idiopathic scoliosis. Eur Spine J 16(1):57-4. doi:10.1007/s00586-006-0063-6 CrossRef
  5. Dold A, Lewis S, Zeller R et al (2012) (PMC3366557) Current trends in the surgical treatment of adolescent idiopathic scoliosis in Canada. Can J Sur 3:55(Suppl) p S38. doi:10.1503/cjs.012212
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  10. Clement JL, Geoffray A, Yagoubi F, Chau E, Solla F, Oborocianu I, Rampal V (2013) Relationship between thoracic hypokyphosis, lumbar lordosis and sagittal pelvic parameters in adolescent idiopathic scoliosis. Eur Spine J 22(11):2414-420. doi:10.1007/s00586-013-2852-z CrossRef
  11. Roussouly P, Labelle H, Rouissi J, Bodin A (2013) Pre- and post-operative sagittal balance in idiopathic scoliosis: a comparison over the ages of two cohorts of 132 adolescents and 52 adults. Eur Spine J 22(Suppl 2):S203–S215. doi:10.1007/s00586-012-2571-x CrossRef
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  14. Langeloo DD, Lelivelt A, Louis Journee H, Slappendel R, de Kleuver M (2003) Transcranial electrical motor-evoked potential monitoring during surgery for spinal deformity: a study of 145 patients. Spine (Phila Pa 1976) 28(10):1043-050. doi:10.1097/01.BRS.0000061995.75709.78
  15. Thuet ED, Winscher JC, Padberg AM, Bridwell KH, Lenke LG, Dobbs MB, Schootman M, Luhmann SJ (2010) Validity and reliability of intraoperative monitoring in pediatric spinal deformity surgery: a 23-year experience of 3436 surgical cases. Spine (Phila Pa 1976) 35(20):1880-886. doi:
• 作者单位：Marinus de Kleuver (1)
  Stephen J. Lewis (2)
  Niccole M. Germscheid (3)
  Steven J. Kamper (4)
  Ahmet Alanay (5)
  Sigurd H. Berven (6)
  Kenneth M. Cheung (7)
  Manabu Ito (8)
  Lawrence G. Lenke (9)
  David W. Polly (10)
  Yong Qiu (11)
  Maurits van Tulder (12)
  Christopher Shaffrey (13)
  
  1. Department of Orthopaedic Surgery, VU University Medicine Center, De Boelelaan 1117, 1081 HZ, Amsterdam, The Netherlands
  2. Department of Surgery, Toronto Western Hospital, Toronto, ON, Canada
  3. Research Department, AOSpine International, Davos, Switzerland
  4. Musculoskeletal Division, The George Institute, University of Sydney, Sydney, NSW, Australia
  5. Department of Orthopaedics and Traumatology, Istanbul Bilim University School of Medicine, Istanbul, Turkey
  6. Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA, USA
  7. Department of Orthopaedics and Traumatology, The University of Hong Kong, Pokfulam Road, Hong Kong, China
  8. Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
  9. Department of Orthopaedic Surgery, Washington University, St. Louis, MO, USA
  10. Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA
  11. Department of Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
  12. Department of Health Sciences, VU University Amsterdam, Amsterdam, The Netherlands
  13. Department of Neurological Surgery, University of Virginia, Charlottesville, VA, USA
  
• ISSN：1432-0932

文摘

Purpose The surgical management of adolescent idiopathic scoliosis (AIS) has seen many developments in the last two decades. Little high-level evidence is available to support these changes and guide treatment. This study aimed to identify optimal operative care for adolescents with AIS curves between 40° and 90° Cobb angle. Methods From July 2012 to April 2013, the AOSpine Knowledge Forum Deformity performed a modified Delphi survey where current expert opinion from 48 experienced deformity surgeons, representing 29 diverse countries, was gathered. Four rounds were performed: three web-based surveys and a final face-to-face meeting. Consensus was achieved with ?0?% agreement. Data were analyzed qualitatively and quantitatively. Results Consensus of what constitutes optimal care was reached on greater than 60 aspects including: preoperative radiographs; posterior as opposed to anterior (endoscopic) surgical approaches; use of intraoperative spinal cord monitoring; use of local autologous bone (not iliac crest) for grafts; use of thoracic and lumbar pedicle screws; use of titanium anchor points; implant density of not constitute optimal care, including: routine pre- and intraoperative traction; routine anterior release; use of bone morphogenetic proteins; and routine postoperative CT scanning. Conclusions International consensus was found on many aspects of what does and does not constitute optimal operative care for adolescents with AIS. In the absence of current high-level evidence, at present, these expert opinion findings will aid health care providers worldwide define appropriate care in their regions. Areas with no consensus provide excellent insight and priorities for future research.