title: Could CCI or FBCI Fully Eliminate the Impact of Curve Flexibility When Evaluating the Surgery Outcome for Thoracic Curve Idiopathic Scoliosis Patient? A Retrospective Study.
abstract: OBJECTIVE
  To clarify if CCI or FBCI could fully eliminate the influence of curve flexibility on the coronal correction rate.
  
  
  METHODS
  We reviewed medical record of all thoracic curve AIS cases undergoing posterior spinal fusion with all pedicle screw systems from June 2011 to July 2013. Radiographical data was collected and calculated. Student t test, Pearson correlation analysis and linear regression analysis were used to analyze the data.
  
  
  RESULTS
  60 were included in this study. The mean age was 14.7 y (10-18 y) with 10 males (17%) and 50 females (83%). The average Risser sign was 2.7. The mean thoracic Cobb angle before operation was 51.9°. The mean bending Cobb angle was 27.6° and the mean fulcrum bending Cobb angle was 17.4°. The mean Cobb angle at 2 week after surgery was 16.3°. The Pearson correlation coefficient r between CCI and BFR was -0.856(P<0.001), and between FBCI and FFR was -0.728 (P<0.001). A modified FBCI (M-FBCI) = (CR-0.513)/BFR or a modified CCI (M-CCI) = (CR-0.279)/FFR was generated by curve estimation has no significant correlation with FFR (r=-0.08, p=0.950) or with BFR (r=0.123, p=0.349).
  
  
  CONCLUSIONS
  Fulcrum-bending radiographs may better predict the outcome of AIS coronal correction than bending radiographs in thoracic curveAIS patients. Neither CCI nor FBCI can fully eliminate the impact of curve flexibility on the outcome of correction. A modified CCI or FBCI can better evaluating the corrective effects of different surgical techniques or instruments.
authors.affiliation: Department of Spine Surgery, Changhai Hospital, the Second Military Medical University, Shanghai, 200433, China.
authors.forename: Changwei
authors.initials: C
authors.lastname: Yang
authors.affiliation: Department of Spine Surgery, Changhai Hospital, the Second Military Medical University, Shanghai, 200433, China.
authors.forename: Xiaofei
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Spine Surgery, Changhai Hospital, the Second Military Medical University, Shanghai, 200433, China; Department of Orthopedics, 304 Hospital of the People's Liberation Army, Beijing, 100048, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Spine Surgery, Changhai Hospital, the Second Military Medical University, Shanghai, 200433, China.
authors.forename: Haijian
authors.initials: H
authors.lastname: Ni
authors.affiliation: Department of Spine Surgery, Changhai Hospital, the Second Military Medical University, Shanghai, 200433, China.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Zhu
authors.affiliation: Department of Nerve Internal Medicine, The General Hospital of the People's Liberation Army, Beijing, 100853, China; Department of Nerve Internal Medicine, Xijing Hospital, the Fourth Military Medical University, Xi'an, 710032, China.
authors.forename: Shichang
authors.initials: S
authors.lastname: Yang
authors.affiliation: Department of Spine Surgery, Changhai Hospital, the Second Military Medical University, Shanghai, 200433, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Li
mesh_terms: D000293:Adolescent; D002648:Child; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects*; D013904:Thoracic Vertebrae / Q000601:surgery; D016896:Treatment Outcome