بررسي ميزان اصلاح دفورميتي و عدم جبران پس از اصلاح اسكوليوز ايديوپاتيك جوانان بر اساس سطح فيوژن در بيمارستان سينا در سال 1378 تا 1382

Study of Postoperative Correction and Decompensation Rate of Juvenile Idiopathic Scoliosis According to Distal Fusion Level in Sina Hospital Between 1998-2002.

Introduction & Objective: Juvenile idiopathic scoliosis king II is the most common type of idiopathic scoliosis and have complex criteria in diagnosis and treatment. Because that is mistakable with other types of scoliosis, and the correct fusion level leads to cosmetic, cardiovascular and emotional complication so that appropriate fusion level is essential. In this study we show that lumbar fusion donʹt increase correction or decrease decompensation and selected thoracic fusion is mandatory. Materials & Methods: In this study we evaluate 20 patients with king II idiopathic scoliosis who had posterior fusion with Variable fusion level from Tn - L3 and have at least a 6 month follow up, between 1998-2002 in Tehran Sina hospital, we measured scoliosis angle by cobbsʹ method and decompensation rate (Deviation > 2cm from plumb line) in plain AP film Just before, after and 6 months postoperatively. Results: We evaluated 20 patient that 6 (30%) was male, 14 (70%) was female. Average age in operation time was 15.25 years, mean follow up was 9 months, mean curve magnitude (preoperative) was 61.85 degrees, mean correction curve (postoperative) was 57.7 percent. In a 6 month follow up none of the patients have decompensation and juvenile kyphosis. Conclusions: Because the lumbar motion is important in spinal biomechanics and according to our study there is no correlation between coronal or sagital plan deccompensation and distal fusion level, we recommended correct selection of the patient and fusion level, avoidance from lumbar segment fusion, thoracic curve overcorrection, (maximum 75%) and post operative close observation.