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The changes of relative position of the thoracic aorta after anterior or posterior instrumentation of type I Lenke curve in adolescent idiopathic thoracic scoliosis

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Abstract

The risk of impingement of the aorta associated with thoracic vertebral screw or pedicle screw instrumentation in the treatment of thoracic scoliosis has been an important concern. To understand this phenomenon more systematically, the relative position of the aorta with reference to the thoracic vertebrae in right thoracic adolescent idiopathic scoliosis (AIS) following anterior and posterior spinal instrumentation was analyzed in detail quantitatively; 34 patients underwent anterior (n = 14) or posterior (n = 20) spinal instrumentation were recruited in the present study. The relative position of the thoracic aorta, vertebral rotation, apical vertebral translation and thoracic kyphosis were measured from pre- and post-operative CT images from T5 to T12. The aorta was found to shift antero-medially in the anterior instrumentation group but not in the posterior spinal instrumentation group. It is likely that the disc removal, soft tissue release and spontaneous vertebral derotation of the scoliosis could account for the antero-medial shifting of the aorta. By the shifting, the space for contralateral screw penetration was reduced.

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Acknowledgment

This work was supported by the National Natural Science Foundation of China (No.30672131).

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Authors and Affiliations

  1. Spine surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China

    Weijun Wang, Zezhang Zhu, Feng Zhu, Bin Wang & Yong Qiu

  2. Department of Diagnostic Radiology and Organ Imaging, The Chinese University of Hong Kong, Hong Kong, China

    Winnie C. W. Chu

  3. Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China

    Jack C. Y. Cheng

  4. The Joint Scoliosis Research Center of Nanjing University and The Chinese University of Hong Kong, Nanjing, China

    Weijun Wang, Winnie C. W. Chu, Jack C. Y. Cheng & Yong Qiu

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  1. Weijun Wang
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  2. Zezhang Zhu
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  3. Feng Zhu
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Correspondence to Yong Qiu.

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Wang, W., Zhu, Z., Zhu, F. et al. The changes of relative position of the thoracic aorta after anterior or posterior instrumentation of type I Lenke curve in adolescent idiopathic thoracic scoliosis. Eur Spine J 17, 1019–1026 (2008). https://doi.org/10.1007/s00586-008-0691-0

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  • DOI: https://doi.org/10.1007/s00586-008-0691-0

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