The Effect of Vertebral Body Tethering on Lumbar Paraspinal Muscle Cross-Section Area in Adolescent Idiopathic Scoliosis
NCT ID: NCT05347056
Last Updated: 2022-04-26
Study Results
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Basic Information
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UNKNOWN
16 participants
OBSERVATIONAL
2022-05-09
2022-06-06
Brief Summary
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Detailed Description
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The incidence of scoliosis is 2-3%, but up to 10% of patients need surgical treatment. Knowing the long-term effects of posterior spinal fusion is currently the gold standard treatment because it gives good results in deformity improvement. However, fusion surgery has disadvantages such as loss of motion in the spine and long-term development of adjacent segment disease and disc degeneration. It has also been suggested that spinal fusion causes iatrogenic damage to the paraspinal muscles (especially the multifidus), which is of great importance in the alignment and movement of the spine due to the posterior approach during surgery.
As a result of damage to the lumbar multifidus muscles and the development of fatty degeneration, problems such as spinal sagittal alignment disorders and chronic low back pain can be seen. In addition, fatty degeneration and atrophy of the paraspinal muscles may lead to the development of adjacent segment disease in the segments under fusion in the long term.
In selective thoracic fusion, by protecting the mobile segments in the lumbar region, the range of motion is preserved and iatrogenic damage of the lumbar paraspinal muscles is prevented. After selective thoracic fusion (STF), some improvement occurs in the deformity in the lumbar region. However, the risk of insufficient improvement and progression of the curve in the unfused lumbar segments, especially in immature patients, should be considered.
Anterior vertebra body tethering is a surgical technique that has been used more frequently in recent years, which is thought to prevent functional complications caused by spinal fusion.With this method, which allows the growth of the spine to continue, there is no need for fusion when treating progressive curvature. Short-term radiological results of this surgical technique have been reported frequently in recent years, but the literature on functional results (spine flexibility, trunk endurance, etc.) is very limited.
In our study, we plan to evaluate the effects of AVT applied to the lumbar region on paraspinal muscle quality, trunk muscle strength and endurance, and trunk joint range of motion by evaluating patients who underwent selective thoracic fusion surgery and patients who underwent thoracic fusion + AVT to the lumbar region.
Conditions
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Study Design
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CASE_CONTROL
OTHER
Study Groups
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Vertebral Body Tethering Group
Vertebral Body Tethering applied to the lumbar region, with or without fusion to the thoracic region
Lumbar Spine Magnetic Resonance
Metal artifact reduction sequence (mars), axial t2 sequence
Isokinetic trunk flexion-extension trunk muscle strength and endurance test
To evaluate for trunk muscle strength and endurance angular velocity of 60 and 120°/s
Lomber Region Range of motion assessment
To evaluate for lomber region ROM with digital inclinometer
Radiograph
spinal radiograph AP/Lateral
SRS 22
SRS-22 Patient Questionnaire
Selective Thoracic Fusion Group
selective thoracic fusion was applied, no intervention was applied to the lumbar region
Lumbar Spine Magnetic Resonance
Metal artifact reduction sequence (mars), axial t2 sequence
Isokinetic trunk flexion-extension trunk muscle strength and endurance test
To evaluate for trunk muscle strength and endurance angular velocity of 60 and 120°/s
Lomber Region Range of motion assessment
To evaluate for lomber region ROM with digital inclinometer
Radiograph
spinal radiograph AP/Lateral
SRS 22
SRS-22 Patient Questionnaire
Interventions
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Lumbar Spine Magnetic Resonance
Metal artifact reduction sequence (mars), axial t2 sequence
Isokinetic trunk flexion-extension trunk muscle strength and endurance test
To evaluate for trunk muscle strength and endurance angular velocity of 60 and 120°/s
Lomber Region Range of motion assessment
To evaluate for lomber region ROM with digital inclinometer
Radiograph
spinal radiograph AP/Lateral
SRS 22
SRS-22 Patient Questionnaire
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
Exclusion Criteria
12 Years
19 Years
ALL
No
Sponsors
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Istanbul University
OTHER
Responsible Party
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Esin Nur Taşdemir
MD
Principal Investigators
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Esin Nur Taşdemir, MD
Role: PRINCIPAL_INVESTIGATOR
Istanbul Medicine Faculty Department of Sports Medicine
Central Contacts
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References
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Green DW, Lawhorne TW 3rd, Widmann RF, Kepler CK, Ahern C, Mintz DN, Rawlins BA, Burke SW, Boachie-Adjei O. Long-term magnetic resonance imaging follow-up demonstrates minimal transitional level lumbar disc degeneration after posterior spine fusion for adolescent idiopathic scoliosis. Spine (Phila Pa 1976). 2011 Nov 1;36(23):1948-54. doi: 10.1097/BRS.0b013e3181ff1ea9.
Pehlivanoglu T, Oltulu I, Erdag Y, Akturk UD, Korkmaz E, Yildirim E, Sarioglu E, Ofluoglu E, Aydogan M. Comparison of clinical and functional outcomes of vertebral body tethering to posterior spinal fusion in patients with adolescent idiopathic scoliosis and evaluation of quality of life: preliminary results. Spine Deform. 2021 Jul;9(4):1175-1182. doi: 10.1007/s43390-021-00323-5. Epub 2021 Mar 8.
Kim HJ, Yang JH, Chang DG, Suk SI, Suh SW, Nam Y, Kim SI, Song KS. Long-Term Influence of Paraspinal Muscle Quantity in Adolescent Idiopathic Scoliosis Following Deformity Correction by Posterior Approach. J Clin Med. 2021 Oct 19;10(20):4790. doi: 10.3390/jcm10204790.
Baroncini A, Trobisch PD, Berrer A, Kobbe P, Tingart M, Eschweiler J, Da Paz S, Migliorini F. Return to sport and daily life activities after vertebral body tethering for AIS: analysis of the sport activity questionnaire. Eur Spine J. 2021 Jul;30(7):1998-2006. doi: 10.1007/s00586-021-06768-6. Epub 2021 Feb 27.
Other Identifiers
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ENTASDEMIR
Identifier Type: -
Identifier Source: org_study_id
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