Correction of scoliosis in arthrogryposis multiplex congenita versus adolescent idiopathic scoliosis
CHEN Zhong-hui
CHEN Xi
WANG Bin
QIU Yong
ZHU Ze-zhang
Qian Bang-ping
LI Song
XU Liang
SUN Xu
Abstract：Objective To compare patients with arthrogryposis multiplex congenita ( AMC ) and age-and deformity-matched patients with adolescent idiopathic scoliosis ( AIS ) to illustrate the differences and identify areas for potential surgical improvement. Methods Twenty-two adolescents with AMC were matched with 44 AIS patients in terms of age, sex, degree of major deformity and follow-up. There were 12 males and 10 females, whose mean age was 14.8 years old ( range:11-18 years old ). Either group received posterior approach only spinal correction and fusion. All patients with AMC and 8 of 44 patients with AIS who had a curve lfexibility less than 30%received multi-level Ponte osteotomy and correction. The operating time, blood loss, fusion levels, correction rate, thoracic kyphosis, lumbar lordosis, sagittal vertical axis ( SVA ) and complications were analyzed and compared between these 2 groups. Results The AMC group had signiifcantly longer operating time [ ( 5.8 ± 1.4 ) h vs. ( 4.3 ± 1.2 ) h, P<0.001 ], signiifcantly more blood loss ( 1640 ml vs. 850 ml, P<0.001 ), and signiifcantly higher levels fused [ ( 13.6 ± 2.2 ) vs. ( 10.3 ± 2.5 ), P<0.001 ]. However, the AMC group had lower correction rate [ ( 42.3 ±11.8 )%vs. ( 64.5 ± 11.6 )%, P<0.001 ] and higher correction loss rate [ ( 4.1 ± 2.8 )%vs. ( 2.6 ± 1.6 )%, P=0.027 ]. Nine patients inAMC group had preoperative pelvic obliquity, with the angle changing from ( 14.2 ± 8.4 ) ° to ( 4.3 ± 3.2 ) ° ( P<0.001 ) after the surgery. The thoracic lordosis and SVA were signiifcantly improved in the AMC group. Seven complications occurred in the AMC group, including 4 cases with screw misplacements, 1 with malignant hyperthermia, 1 with transient dyspnea and 1 with neurological defect, while there was only 1 complication with screw misplacement in AIS group. Conclusions Correction of scoliosis in patients with AMC tends to require longer operating time, and higher fusion levels than AIS, and results in less correction, more blood loss and more complications. In addition, more attention should be paid to pelvic obliquity and sagittal hyperlordosis in AMC patients.
Keywords：ArthrogryposisScoliosisSpinal curvaturesOrthopedic procedures
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 33-37 )