Canales NJA, Hurtado PA, Guzmán ALA

Language: Spanish
References: 16
Page: 151-156
PDF size: 246.42 Kb.

ABSTRACT

Introduction: the vertebral column results in a dynamic complex made up of connective and bone tissue that is intended to resist axial loads due to the human body. Idiopathic Scoliosis is a complex three-dimensional alteration of the spine in children over 10 years of age, which is defined with a Cobb angle of 10° or more in addition to a rotational component. For its evaluation, the use of imaging studies is of importance, in this case the main one is the simple panoramic x-ray plate of the spine, with the use of the measurement of the Cobb angle and is based on the drawing of parallel lines associated with the upper and lower vertebral platform of the vertebrae of the distal and proximal vertebrae. Lenke's classification is based on an organizational system according to six types of curves with a thoracic sagittal modifier (-, N, +) and a lumbar modifier (A, B, C). The Adding-on phenomenon in adolescent idiopathic scoliosis is characterized by a progressive loss of correction with an increase in deviation of the vertebral body of the lumbar spine or disc angulation below the level of instrumentation. Research question: what are the factors that influence the appearance of the Adding-on phenomenon in postoperative adolescent idiopathic scoliosis patients? Hypothesis: there will be risk factors that are associated with the post-surgical appearance of the Adding-on phenomenon in patients with adolescent idiopathic scoliosis. Objective: the risk factors associated with the appearance of the Adding-on phenomenon in the population of the Shriners Hospital for Children in Mexico were analyzed. Age and sex, Risser sign, Cobb angle and the smallest instrumented vertebra as a factor associated with the appearance of the adding-on phenomenon. Material and methods: a sample of 109 patients was obtained from the population of the scoliosis clinic at the Shriners Hospital for Children in Mexico. A cross-sectional, analytical, observational and retrospective study was carried out. Variables: adding-on phenomenon, Cobb angle, last instrumented vertebra, Risser sign. Statistical analysis: The Kolmogorov-Smirnov tests were performed, finding normality within the sample, the Mann-Whitney U test, in addition to the χ² test, without finding a statistically significant relationship for its association between the variables studied and the appearance of the studied phenomenon. Results: in this way, we obtained 106 patients from a total population of 150 performing an observation in the PACS radiography program of the Shriners Hospital for Children in Mexico in addition to the databases belonging to the same hospital, of which 94 were female, constituting 89% of the treated sample, leaving 10.5% of males with a total of 11 patients. Furthermore, it was found that the incidence of transpedicular fixation was around 15 years with 25.7% of total cases. Conclusion: we can confirm that factors such as age, gender, as well as skeletal maturity are not significant for the appearance of the adding on phenomenon, although it may be due to the size of the sample at the moment.

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