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- W2969996034 abstract "BACKGROUND CONTEXT Minimizing the fusion levels in PSF for AIS is important. Previous studies have shown good results utilizing TV as the lowest instrumental vertebrae (LIV). TV is the ‘touched’ vertebra determined by central sacral vertical line on standing AP XRs (TVS). We have found that TV moves proximally on supine/prone radiographs. Thus utilizing TV on prone XR (TVP) in LIV decision making may allow even shorter fusion. PURPOSE To assess whether the use of TVP to determine LIV saves fusion levels while maintaing good correction and coronal balance. STUDY DESIGN/SETTING Ambispective cohort study. PATIENT SAMPLE Group I contained 102 patients, undergoing PSF, in who TVP was used to determine LIV. Group II contained 26 patients, undergoing PSF, in who TVS was used to determine LIV. Group III contained 132 nonoperative AIS patients. Patients with only thoracic fusion were excluded. OUTCOME MEASURES Cobb angle, coronal balance (CB), LIV tilt angle and translation, and disc wedging were collected preoperatively and postoperatively. METHODS There were three groups. Group I: patients where TVP was used to determine LIV. Group II: patients where TVS was used to determine LIV. Group III: nonoperative AIS (Risser 4/5, Cobb RESULTS The control group had 132 patients with a median (IQR) Cobb of 20° (16-26), age of 16 (14.8-17), coronal balance 1.4 (0.5-2.2), disc wedging of 4° (2-5), and LIV tilt of 10° (7-13). In Group I (n=102), median preoperative Cobb was 53.8° and coronal balance was 1.8. Final Cobb was 12.4° and coronal balance was 0.9. Compared to controls, Group I patients had significantly less coronal imbalance (p =0.023), lower disc wedging (p>0.001) and LIV tilt (p 5° (p CONCLUSIONS In AIS, using TVP to determine LIV allows for shorter fusion. LIV tilt and disc wedging is also within ‘acceptable’ levels determined on controls. TVP is an effective and better way to determine the lowest instrumented vertebra. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs." @default.
- W2969996034 created "2019-08-29" @default.
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- W2969996034 date "2019-09-01" @default.
- W2969996034 modified "2023-09-23" @default.
- W2969996034 title "P101. Determining lowest instrumental vertebrae (LIV) on prone X-ray studies can save fusion levels with good correction and balance in AIS patients compared to traditional methods" @default.
- W2969996034 doi "https://doi.org/10.1016/j.spinee.2019.05.526" @default.
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