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Preoperative CT Angiography Informs Instrumentation in Anterior Spine Surgery for Idiopathic Scoliosis

Overview
Specialty Orthopedics
Date 2020 May 8
PMID 32377614
Citations 2
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Abstract

Methods: Children with idiopathic scoliosis who underwent anterior instrumentation and with a preoperative CT angiography were evaluated retrospectively. Data included curve type, artery of Adamkiewicz level/laterality, surgical approach laterality, number of instrumented levels and segmental vessels ligated, intraoperative neuromonitoring changes, and postoperative neural complications.

Results: Thirty-nine girls and eight boys (mean age 12 years [6.7 to 16.8 years]) were analyzed. Instrumented curves indicate 28 thoracic, 14 thoracolumbar, and seven double major. The artery of Adamkiewicz: T6 (left-1), T8 (left-1), T9 (left-4/right-2), T10 (left-11/right-4), T11 (left-4/right-4), T12 (left-1/right-2), L1 (left-2/right-1), and L2 (left-3/right-2). Four had bilateral dominant segmentals, whereas in nine patients, none was identified. T10 (32%) and left side (57%) were most frequent. On average, 7.1 (4 to 11) segmentals were ligated case (total 355). Dominant vessels were ipsilateral to/within instrumentation levels in 30%.

Discussion: In children with idiopathic scoliosis who underwent anterior instrumentation, the artery of Adamkiewicz was identified on the left in >50% and at T10 in 32%. In one-third of the patients, the artery was within intended surgical levels and resulted in instrumentation modification.

Citing Articles

Identification of the Magna Radicular Artery Entry Foramen and Adamkiewicz System: Patient Selection for Open versus Full-Endoscopic Thoracic Spinal Decompression Surgery.

Vargas R, De Olinveira E, Moscatelli M, Leon J, Lorio M, Fiorelli R J Pers Med. 2023; 13(2).

PMID: 36836589 PMC: 9964931. DOI: 10.3390/jpm13020356.


Thoracic posterior spinal instrumented fusion vs. thoracic anterior spinal tethering for adolescent idiopathic scoliosis with a minimum of 2-year follow-up: a cost comparison of index and revision operations.

Theologis A, Wu H, Diab M Spine Deform. 2022; 11(2):359-366.

PMID: 36131225 DOI: 10.1007/s43390-022-00586-6.

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