How Sublaminar Bands Affect Postoperative Sagittal Alignment in AIS Patients with Preoperative Hypokyphosis? Results of a Series of 34 Patients with 2-Year Follow-Up

• Pesenti Sebastien
• Chalopin Antoine
• Peltier Emilie
• Choufani Elie
• Ollivier Matthieu
• Fuentes Stéphane
• Blondel Benjamin
• Jouve Jean-Luc

Hypokyphosis is currently observed in thoracic idiopathic scoliosis. The use of sublaminar bands allows a good restoration of sagittal balance of the spine. The aim of the study was to provide a middle-term radiographic analysis of patients with adolescent idiopathic scoliosis with preoperative hypokyphosis treated by posterior arthrodesis with sublaminar bands. This retrospective study included 34 patientswith Lenke 1 scoliosis associated with hypokyphosis ( TK < 20 degrees). Aradiographic evaluation was performed with a 2-year follow-up. Cobb angle, cervical lordosis, thoracic kyphosis, lumbar lordosis, and pelvic parameters were measured preoperatively, postoperatively, and at 6-month and 2-year follow-up. The mean preoperative thoracic kyphosis was 10.5 degrees versus 24.1 degrees postoperatively (p < 0.001), representing amean gain of 13 degrees. Cobb angle ranged from 59.3 degrees to 17.9 degrees postoperatively (mean correction 69%, p < 0.001). Cobb angle increased between the immediate postoperative measurement and the 6-month follow-up (17.9 versus 19.9, p - 0.03). Cervical curvature changed from a 5.6 degrees kyphosis to a 3.5 degrees lordosis (p - 0.001). Concerning lumbar lordosis, preoperative measurement was 39.7 degrees versus 41.3 degrees postoperatively (p = 0.27). At 6-month follow-up, lumbar lordosis significantly increased to 43.6 degrees (p = 0.03). All parameters were stable at final follow-up. Correction performed by sublaminar bands is efficient for both fontal and sagittal planes. Moreover, the restoration of normal thoracic kyphosis is followed by an adaptation of the adjacent curvatures with improved cervical lordosis and lumbar lordosis.