Volume 7 Supplement 1

8th International Conference on Conservative Management of Spinal Deformities and SOSORT 2011 Annual Meeting

Open Access

Are routine postoperative X-Rays justified in adolescent idiopathic scoliosis?

  • A Vila-Casademunt1,
  • F Pellisé2,
  • M Domingo-Sàbat1,
  • J Bagó2,
  • A Matamalas2,
  • C Villanueva2 and
  • E Cáceres2
Scoliosis20127(Suppl 1):O13

DOI: 10.1186/1748-7161-7-S1-O13

Published: 27 January 2012

Background

The clinical relevance of X-ray findings may not justify routine postoperative radiographic controls at 0, 3, 6, 12, and 24 months in adolescent idiopathic scoliosis (AIS) patients undergoing instrumented fusion with third-generation implants.

Materials and methods

Full-spine X-rays and clinical records from the first 2 years’ postoperative follow-up in all AIS patients who underwent instrumented fusion in our center between 2005 and 2008 were independently analyzed by 2 investigators (consensus for discrepancies). The reviewers sought any clinical feature justifying X-ray control and any relevant radiologic finding [1].

Results

Records from 43 patients (mean age 16.5 years, 93% women) were evaluated. A total of 414 (212 posteroanterior, 202 lateral) full-spine X-rays (9.6/patient) were performed during the first 2 postoperative years: 392 were available for analysis, and 391 had an associated clinical note. Excluding the 89 immediate postoperative films, only 48 of 325 (14.8%) were clinically justified: pain in 17 (34%) patients, clinical progression of deformity in 4 (8%) and previous X-ray finding in 29 (58%). All patients with clinical progression had a relevant X-ray finding. Pain was associated with a relevant finding in 23.5% of cases (positive predictive value 0.1); 7.4% of films with no clinical justification showed a relevant finding (negative predictive value 0.86). Only 4.3% of films led to a therapy change. Lower Risser sign increased the risk of having a relevant radiographic finding (p<0.05).

Conclusions

Routine 3, 6, 12, and 24-month postoperative X-rays are not justified in AIS and should be avoided in mature, uncomplicated cases.

Authors’ Affiliations

(1)
Fundació Institut de Recerca Vall Hebron
(2)
Hospital Vall Hebron

References

  1. Lowe T, Berven SH, Schwab FJ, Bridwell KH: The SRS classification for adult spinal deformity: building on the King/Moe and Lenke classification systems. Spine. 2008, 33 (20): 2243-7. 10.1097/BRS.0b013e31817d1d4e.View ArticleGoogle Scholar

Copyright

© Vila-Casademunt et al; licensee BioMed Central Ltd. 2012

This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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