ABSTRACT

Objective:

To investigate the association between shoulder imbalance and AVR (apical vertebrae rotation) with AVR related ratios and how these radiological parameters effects patients postoperative functional and cosmetic outcomes by using SRS-22r scoring system.

Methods:

Adolescent Idiopathic scoliosis patients (n: 48) treated with posterior spinal surgery and followed up for more than 1 years were evaluated retrospectively. The rotation angle of the apical vertebra was measured using Drerup’s AVR measuring method in coronal plane radiograph. AVR improvement rate were calculated. Preoperative and postoperative follow-up shoulder balances were assessed by measuring CTAD (clavicular tilt angle difference) in the standing graphs.

Results:

According to the Pearson Correlation test there was a statistically mild negative correlation between postoperative shoulder balance and age of operation. There was an inverse moderate correlation between early postoperative apical vertebral rotation and postoperative shoulder balance. According to other tests (Benferroni ve Pillai’s Trace), AVR of patients with shoulder imbalance seems to have not improved in the postoperative period. Shoulder imbalance was found to be statistically significant in patients with poorly corrected postoperative AVR. Patients with good shoulder balance appeared to be composed of patients who showed better AVR recovery significantly in the early postoperative period.

Conclusion:

Using early postoperative AVR recovery in evaluating the surgical outcomes of patients with adolescent idiopathic scoliosis and the evaluation of follow-up progression may provide important contributions to orthopedic surgery. Nevertheless, there is a need for large populations and long follow-up studies to support this thinking.