Articles

Assessment of Average Correction of Cobb’s Angle Post Instrumentation in Adolescent Idiopathic Scoliosis in Lenknee Type 1 Curve

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Introduction: Preferred instrumentation for adolescent idiopathic scoliosis (AIS) remains controversial. Surgical correction is classically indicated for progressive curves more than 40° in the skeletally immature patient.

Aims and objectives: The basic aim of the study is to analyse the average correction of Cobb’s angle post instrumentation in adolescent ideopathic scoliosis in lenknee type 1 curve.

Material and methods: This descriptive study was conducted in Services hospital, Lahore during 2020 to 2021. This study was done with the approval of ethical committee of hospital. There are 27 patients that were included in this study. The age range for the selected patients was 14-20 years from which 15 female and 12 male. The total duration of the study was 2 years.

Results: The data was collected from 27 patients.  In three patients with Lenke type 1 curve, the apex of curve was the disc at T8/9 or the vertebral body at T9. The mean coronal Cobb angle of the main thoracic curve was 43.7° and the Cobb angles of the compensatory curves on thoracolumbar or lumbar region were less than 20°. On scoliometer measurement of the rib hump averaged 18.5°. On the lateral bending film the mean Cobb angle of main thoracic curve was corrected to 15.7°.

Conclusion: It is concluded that patients with Lenke 1 increasing the cost density of instrumentation does not translate into improving the Cobb angle of the uninstrumented spine and does not change any of the cosmetic parameters measured on clinical patient photographs.

Average Correction of Cobb’s Angle in Congenital Scoliosis Using Growing Rode as a Mode of Correction

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Introduction: Scoliosis with rotational imbalance is mainly characterized by the vertebral rotation related to the curve in the coronal plan.
Aims and objectives: The basic aim of the study is to assess the average correction of Cobb’s angle in congenital scoliosis using growing rode as a mode of correction.
Material and methods: This descriptive study was conducted in DHQ hospital Sargodha during 2019 to 2021 for the period of two years. The data was collected with the permission of ethical committee of hospital. The data was collected from 12 patients from age range 4-12 years. Among that 12 patients there were 7 male and 5 female patients. We carried out a convenience sampling, including all scoliosis patients who received surgical treatment with elongating rods in the period studied, and excluded all patients diagnosed with syndromic scoliosis, and with incomplete records in their clinical history.
Results: There were 12 patients of scoliosis under 10 were reviewed. Of these, 35 (5%) required surgical treatment with growing rods and met the selection criteria. The presurgical and postsurgical radiographic change showed a 47.7% reduction in the Cobb angle (31.8° ± 14.6° difference), which was statistically significant (p<0.001; t-student). During the study period, 8 patients showed some procedure-related complication; another 2 patients (22.9%) showed instrumentation failures, and 2 cases (5.7%) showed infection in the operated area which, it should be noted, was associated with instrumentation failure. Univariate analysis was performed to define which variables could be potential predictor factors of complications in our patient sample. Conclusion: Treatment of scoliosis in patients under age 10 with growing rods has achieved a significant reduction in the magnitude of the deformity before final bone fusion.