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Purpose <p>To evaluate a novel proximal thoracic concave rod (PTCR) technique for improving postoperative shoulder imbalance (SI) in adolescent idiopathic scoliosis (AIS) patients with Lenke types 2 and 4 curves, compared to conventional methods.</p> Methods <p>A retrospective study of 30 AIS patients (10 with PTCR, 20 without) from a multicentric European database was conducted. Patients aged ≤ 18 years undergoing surgery for Lenke types 2 or 4 curves with ≥ 2 years of follow-up were included. Radiographic parameters, including Clavicle Angle (CA) and T1 Coronal Tilt (T1CT), were assessed preoperatively, immediately postoperatively, and at 2&#xa0;years. Demographic, surgical, radiological parameters, and patient-reported outcomes measures (PROMs) were compared between groups.</p> Results <p>PTCR significantly improved SI, achieving optimal CA in 80% of cases versus 35% in the non-PTCR group (p = 0.02). CA correction was superior in the PTCR group (−1.66° ± 1.34° vs. 1.06 ± 2.59°, p &lt; 0.001). While T1CT correction showed greater improvement in the PTCR group (−3.62° ± 5.56° vs. −0.31° ± 8.13°) it was not statistically significant (p = 0.258). PTCR did not increase surgical time, blood loss, or complications.</p> Conclusions <p>PTCR is a promising approach for managing shoulder imbalance in AIS patients with Lenke types 2 or 4 curves. Larger prospective studies are necessary to validate these findings.</p> Level of Evidence <p>Level of Evidence: III.</p>

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Improving shoulder balance in lenke type 2 and 4 adolescent idiopathic scoliosis: clinical advantages of a proximal thoracic concave rod technique

  • 期刊论文

  • 发表日期：

    2025年8月14日

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  • Ibrahim Obeid,
  • Lluís Vila,
  • Louis Boissière,
  • Cécile Roscop,
  • Alice Baroncini,
  • Yann Philippe Charles,
  • Ferran Pellisé,
  • Javier Pizones,
  • Ahmet Alanay,
  • Frank Kleinstück,
  • Daniel Larrieu,
  • Anouar Bourghli,
  • Ferran Pellisé,
  • Ahmet Alanay,
  • Ibrahim Obeid,
  • Frank Kleinstück,
  • Yann Philippe Charles,
  • Javier Pizones,
  • Sleiman Haddad,
  • Susana Núñez-Pereira,
  • Louis Boissière,
  • Daniel Larrieu,
  • Anika Pupak,
  • Cécile Roscop,
  • Çaglar Yilgor,
  • Altug Yucekul,
  • Alejandro Gómez-Rice,
  • Anne F. Manion,
  • Markus Loibl,
  • Lucía Moreno,
  • Tais Zulemyan,
  • Sarah Richner

摘要

Purpose

To evaluate a novel proximal thoracic concave rod (PTCR) technique for improving postoperative shoulder imbalance (SI) in adolescent idiopathic scoliosis (AIS) patients with Lenke types 2 and 4 curves, compared to conventional methods.

Methods

A retrospective study of 30 AIS patients (10 with PTCR, 20 without) from a multicentric European database was conducted. Patients aged ≤ 18 years undergoing surgery for Lenke types 2 or 4 curves with ≥ 2 years of follow-up were included. Radiographic parameters, including Clavicle Angle (CA) and T1 Coronal Tilt (T1CT), were assessed preoperatively, immediately postoperatively, and at 2 years. Demographic, surgical, radiological parameters, and patient-reported outcomes measures (PROMs) were compared between groups.

Results

PTCR significantly improved SI, achieving optimal CA in 80% of cases versus 35% in the non-PTCR group (p = 0.02). CA correction was superior in the PTCR group (−1.66° ± 1.34° vs. 1.06 ± 2.59°, p < 0.001). While T1CT correction showed greater improvement in the PTCR group (−3.62° ± 5.56° vs. −0.31° ± 8.13°) it was not statistically significant (p = 0.258). PTCR did not increase surgical time, blood loss, or complications.

Conclusions

PTCR is a promising approach for managing shoulder imbalance in AIS patients with Lenke types 2 or 4 curves. Larger prospective studies are necessary to validate these findings.

Level of Evidence

Level of Evidence: III.