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Chan CYW, Tan YWE, Chandren JR, Chandirasegaran S, Chung WH, Chiu CK, Kwan MK. Prediction of postoperative curve correction based on the supine radiographs for adult idiopathic scoliosis (AdIS) patients. Spine J 2024:S1529-9430(24)00111-6. [PMID: 38499066 DOI: 10.1016/j.spinee.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 02/22/2024] [Accepted: 03/12/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND CONTEXT Preoperative supine radiographs are mandatory in the new adult idiopathic scoliosis (AdIS) classification. Supine radiographs are easily reproducible and highly predictive of side bending radiographs. However, few studies evaluated the use of supine radiographs in predicting postoperative curve correction after posterior spinal fusion (PSF) in AdIS. PURPOSE To investigate the use of supine and side bending (SB) radiographs in predicting postoperative curve correction in AdIS patients who underwent PSF. STUDY DESIGN Retrospective study. PATIENT SAMPLE 93 AdIS patients who underwent PSF between 2022 and 2023 were included. OUTCOME MEASURES Demographic data were age, gender, height, weight, body mass index (BMI), Risser grade, Lenke curve types and Cobb angles. Main outcome measures were preoperative and immediate postoperative Cobb angle (proximal thoracic [PT], main thoracic [MT] and thoracolumbar/lumbar [TL/L] curves), Supine Cobb angle and Flexibility rate (PT, MT and TL/L), and Correction rate (PT, MT and TL/L). METHODS Correlation study was performed between Supine Cobb angle vs. postoperative Cobb angle for PT, MT and TL/L curves. A predictive formula was derived from the correlation plots. RESULTS A total of 93 subjects were included in our study with a median age of 24.7 years and comprised of 80 females (86.0%). Preoperative Supine Cobb angle (r=0.835, r=0.881, r=0.767, p<.001) and preoperative SB Cobb angle (r=0.815, r=0.872, r=0.801, p<.001) showed similar strong positive correlation with postoperative PT, MT and TL/L Cobb angle, but preoperative Supine Cobb angle had slightly stronger correlation in PT and MT, whereas preoperative SB Cobb angle had stronger correlation in TL/L curve. Using the derived predictive formulae, there was a significant, strong, positive correlation between the predicted value and actual value of postoperative standing Cobb angle, (r=0.852, p<.001), with 71.0% of the patients had predicted postoperative Cobb angle from the supine radiographs within 5 degrees of the actual value. CONCLUSION Both supine radiographs and side bending radiographs had strong predictability of the postoperative Cobb angle for PT, MT and TL/L curves. In 71.0% of patients, the actual postoperative Cobb angle was within 5 degrees of the predicted postoperative Cobb angle using the predictive formulae.
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Affiliation(s)
- Chris Yin Wei Chan
- Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
| | - Yee Wern Evonne Tan
- Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Josephine Rebecca Chandren
- Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | | | - Weng Hong Chung
- Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Chee Kidd Chiu
- Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Mun Keong Kwan
- Department of Orthopaedic Surgery (NOCERAL), Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
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Lee YJ, Wang WJ, Mohamad SM, Chandren JR, Gani SMA, Chung WH, Chiu CK, Chan CYW. A comparison between Boston brace and European braces in the treatment of adolescent idiopathic scoliosis (AIS) patients: a systematic review based on the standardised Scoliosis Research Society (SRS) inclusion criteria for brace treatment. Eur Spine J 2024; 33:630-645. [PMID: 37924388 DOI: 10.1007/s00586-023-08007-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/01/2023] [Accepted: 10/15/2023] [Indexed: 11/06/2023]
Abstract
PURPOSE To compare the Boston brace and European braces using a standardised Scoliosis Research Society (SRS) inclusion criteria for brace treatment as well as consensus recommendations for treatment outcome. METHODS This was a systematic review that was carried out using MeSH terminology in our search protocol in PubMed, Cochrane Library, Scopus, Clinicaltrials.gov and Web of Science database between 1976 and 29th of Jan 2023. All studies that were included in this review had applied fully/partially the SRS inclusion criteria for brace wear. Outcome measures were divided into primary and secondary outcome measures. RESULTS 3830 literatures were found in which 176 literatures were deemed relevant to the study once duplicates were removed and titles and abstracts were screened. Of these literatures, only 15 had fulfilled the eligibility criteria and were included in the study. 8 of the studies were Level IV studies, 5 were Level III studies and 2 studies were Level I studies (1 prospective randomised controlled trial (RCT) and 1 Quasi-RCT). The percentage of patients who avoided surgery for European braces ranged from 88 to 100%, whereas for Boston brace ranged from 70 to 94%. When treatment success was assessed based on the final Cobb angle > 45°, approximately 15% of patients treated with European braces had treatment failure. In contrast, 20-63% of patients treated with Boston brace had curves > 45° at skeletal maturity. The BrAIST study used a cut-off point of 50° to define failure of treatment and the rate of treatment failure was 28%. Curve correction was not achieved in most patients (24-51% of patients) who were treated with the Chêneau brace and its derivatives. However, none of the patients treated with Boston brace achieved curve correction. CONCLUSION Boston brace and European braces were effective in the prevention of surgery. In addition, curve stabilisation was achieved in most studies. Limitation in current literature included lack of studies providing high level of evidence and lack of standardisation in terms of compliance to brace as well as multidisciplinary management of brace wear.
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Affiliation(s)
- Yu Jie Lee
- Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Wee Jieh Wang
- Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Siti Mariam Mohamad
- Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Josephine Rebecca Chandren
- Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Siti Mariam Abd Gani
- Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Weng Hong Chung
- Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Chee Kidd Chiu
- Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Chris Yin Wei Chan
- Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia.
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Chiu CK, Chan CYW, Chandren JR, Ong JY, Loo SF, Hasan MS, Kwan MK. Letters about Published Papers. J Orthop Surg (Hong Kong) 2020; 27:2309499019861233. [PMID: 31362584 DOI: 10.1177/2309499019861233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Chee Kidd Chiu
- 1 Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning, University of Malaya, Kuala Lumpur, Malaysia
| | - Chris Yin Wei Chan
- 1 Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning, University of Malaya, Kuala Lumpur, Malaysia
| | - Josephine Rebecca Chandren
- 1 Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning, University of Malaya, Kuala Lumpur, Malaysia
| | - Jun Yin Ong
- 1 Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning, University of Malaya, Kuala Lumpur, Malaysia
| | - Shweh Fern Loo
- 1 Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning, University of Malaya, Kuala Lumpur, Malaysia
| | - Mohd Shahnaz Hasan
- 2 Department of Anaesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Mun Keong Kwan
- 1 Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning, University of Malaya, Kuala Lumpur, Malaysia
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Chiu CK, Chan CYW, Chandren JR, Ong JY, Loo SF, Hasan MS, Kwan MK. After-hours elective spine deformity corrective surgery for patients with Adolescent Idiopathic Scoliosis: Is it safe? J Orthop Surg (Hong Kong) 2020; 27:2309499019839023. [PMID: 30947617 DOI: 10.1177/2309499019839023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The aim of this study was to compare the outcome of after-hours electively planned Posterior Spinal Fusion surgeries for Adolescent Idiopathic Scoliosis (AIS) patients with daytime surgeries. METHODS This was a retrospective propensity score-matched study using prospectively collected data. Surgeries performed between 08:00 and 16:59 h were labeled as daytime surgeries (group 1) and surgeries performed between 17:00 and 06:00 h were labeled as after-hours surgeries (group 2). The perioperative outcome parameters were average operation time in and out, operation duration, intraoperative blood loss, blood transfusion, intraoperative hemodynamic parameters, preoperative hemoglobin, postoperative hemoglobin, and total patient-controlled anesthesia (PCA) morphine usage. Radiological variables assessed were Lenke subtypes, preoperative Cobb angle, number of fusion levels, number of screws used, postoperative Cobb angle, correction rate, side bending flexibility, side bending correction index, complications rate, and length of hospitalization. RESULTS Average operation time in for daytime group was 11:32 ± 2:33 h versus 18:20 ± 1:05 h in after-hours group. Comparing daytime surgeries with after-hours surgeries, there were no significant differences ( p > 0.05) in the operation duration, intraoperative blood loss, intraoperative pH, bicarbonate, lactate, postoperative hemoglobin, hemoglobin drift, blood transfusion, postoperative Cobb angle, correction rate, side bending flexibility, side bending correction index, length of hospitalization, and complications rate. Total PCA morphine usage was significantly lesser in the after-hours group (18.2 ± 15.3 mg) compared with the daytime group (24.6 ± 16.6 mg; p = 0.042). CONCLUSIONS After-hours elective spine deformity corrective surgeries for healthy ambulatory patients with AIS were as safe as when they were done during daytime.
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Affiliation(s)
- Chee Kidd Chiu
- 1 Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning, University of Malaya, Kuala Lumpur, Malaysia
| | - Chris Yin Wei Chan
- 1 Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning, University of Malaya, Kuala Lumpur, Malaysia
| | - Josephine Rebecca Chandren
- 1 Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning, University of Malaya, Kuala Lumpur, Malaysia
| | - Jun Yin Ong
- 1 Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning, University of Malaya, Kuala Lumpur, Malaysia
| | - Shweh Fern Loo
- 1 Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning, University of Malaya, Kuala Lumpur, Malaysia
| | - Mohd Shahnaz Hasan
- 2 Department of Anaesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Mun Keong Kwan
- 1 Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning, University of Malaya, Kuala Lumpur, Malaysia
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Khor CS, Hassan H, Mohd-Rahim NF, Chandren JR, Nore SS, Johari J, Loong SK, Abd-Jamil J, Khoo JJ, Lee HY, Pike BL, Li-Ping W, Lim YAL, AbuBakar S. Seroprevalence of Borrelia burgdorferi among the indigenous people (Orang Asli) of Peninsular Malaysia. J Infect Dev Ctries 2019; 13:449-454. [PMID: 32053515 DOI: 10.3855/jidc.11001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 03/26/2019] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Lyme disease has been well-described in the North America and European countries. However, information is still very limited in the developing countries including Malaysia. The Orang Asli (OA), the indigenous people of Peninsular Malaysia reside mostly in the forest and forest fringe areas abundant with the vector for Lyme disease. Here, we described the seroprevalence of Borellia burgdorferi (B. burgdorferi) among the OA and demographic variables that could be associated with seroprevalence. METHODOLOGY A total of 16 OA villages distributed across 8 states in Peninsular Malaysia participated in this study. Sera obtained from 904 OA volunteers were screened for anti-B. burgdorferi IgG antibodies. ELISA results obtained and demographic information collected were analysed to identify possible variables associated with seroprevalence. RESULTS A total of 73 (8.1%) OA tested positive for anti-B. burgdorferi IgG antibodies. Among all the variables examined, village of residence (p = 0.045) was the only significant predictor for seropositivity. High (> 10.0%) prevalence was associated with three OA villages. Those living in one particular village were 1.65 times more likely to be seropositive as compared to other OA villages. Age, gender, marital status, household size, level of education, monthly household income and occupation were not significant predictors for seropositivity. CONCLUSION Results of the present study support earlier findings that B. burgdorferi infection among Malaysians is currently under-recognized. Further studies will be needed at these locations to confirm the presence of Lyme disease among these populations.
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Affiliation(s)
- Chee-Sieng Khor
- Tropical Infectious Diseases Research and Education Centre (TIDREC), University of Malaya, Kuala Lumpur, Malaysia.
| | - Habibi Hassan
- Tropical Infectious Diseases Research and Education Centre (TIDREC), University of Malaya, Kuala Lumpur, Malaysia.
| | - Nurul-Farhana Mohd-Rahim
- Tropical Infectious Diseases Research and Education Centre (TIDREC), University of Malaya, Kuala Lumpur, Malaysia.
| | - Josephine Rebecca Chandren
- Department of Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Siti-Sarah Nore
- Tropical Infectious Diseases Research and Education Centre (TIDREC), University of Malaya, Kuala Lumpur, Malaysia.
| | - Jefree Johari
- Tropical Infectious Diseases Research and Education Centre (TIDREC), University of Malaya, Kuala Lumpur, Malaysia.
| | - Shih-Keng Loong
- Tropical Infectious Diseases Research and Education Centre (TIDREC), University of Malaya, Kuala Lumpur, Malaysia.
| | - Juraina Abd-Jamil
- Tropical Infectious Diseases Research and Education Centre (TIDREC), University of Malaya, Kuala Lumpur, Malaysia.
| | - Jing-Jing Khoo
- Tropical Infectious Diseases Research and Education Centre (TIDREC), University of Malaya, Kuala Lumpur, Malaysia.
| | - Hai-Yen Lee
- Tropical Infectious Diseases Research and Education Centre (TIDREC), University of Malaya, Kuala Lumpur, Malaysia.
| | - Brian L Pike
- U.S. Naval Medical Research Center - Asia, Singapore.
| | - Wong Li-Ping
- Department of Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Yvonne Ai-Lian Lim
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Sazaly AbuBakar
- Tropical Infectious Diseases Research and Education Centre (TIDREC), University of Malaya, Kuala Lumpur, Malaysia.
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Khor CS, Mohd-Rahim NF, Hassan H, Chandren JR, Nore SS, Johari J, Loong SK, Abd-Jamil J, Khoo JJ, Lee HY, Pike BL, Wong LP, Lim YAL, Zandi K, AbuBakar S. Seroprevalence of Q Fever Among the Indigenous People (Orang Asli) of Peninsular Malaysia. Vector Borne Zoonotic Dis 2018; 18:131-137. [PMID: 29336685 DOI: 10.1089/vbz.2017.2153] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Q fever is a disease caused by Coxiella burnetii. It is a disease of public health concern in many parts of the world. In this study, we described the seroprevalence of Q fever among selected populations of Orang Asli (OA), indigenous people, many of whom live within the forest fringe areas of Peninsular Malaysia. Serum samples were obtained from 887 OA participants from selected villages. Samples were analyzed for the presence of IgG antibodies reactive against C. burnetii by enzyme-linked immunosorbent assay. Statistical methods were used to identify possible associations between seropositivity for C. burnetii and a number of demographic variables obtained from the questionnaires. In total, 9.6% (n = 85/887) of the serum samples were reactive to C. burnetii. Statistical results suggest that elderly male OA residing in OA village, Bukit Payung, were most likely to be tested seropositive for C. burnetii. This study suggests that OA are at a significant risk of contracting C. burnetii infection, and both demographic and geographic factors are important contributors to this risk. Further prospective studies are needed to establish the true burden of C. burnetii infection within the indigenous population as well as within Peninsular Malaysia as a whole.
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Affiliation(s)
- Chee-Sieng Khor
- 1 Tropical Infectious Diseases Research & Education Centre (TIDREC), University of Malaya , Kuala Lumpur, Malaysia
| | - Nurul-Farhana Mohd-Rahim
- 1 Tropical Infectious Diseases Research & Education Centre (TIDREC), University of Malaya , Kuala Lumpur, Malaysia .,2 Department of Medical Microbiology, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia
| | - Habibi Hassan
- 1 Tropical Infectious Diseases Research & Education Centre (TIDREC), University of Malaya , Kuala Lumpur, Malaysia .,2 Department of Medical Microbiology, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia
| | - Josephine Rebecca Chandren
- 3 Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia
| | - Siti-Sarah Nore
- 1 Tropical Infectious Diseases Research & Education Centre (TIDREC), University of Malaya , Kuala Lumpur, Malaysia
| | - Jefree Johari
- 1 Tropical Infectious Diseases Research & Education Centre (TIDREC), University of Malaya , Kuala Lumpur, Malaysia
| | - Shih-Keng Loong
- 1 Tropical Infectious Diseases Research & Education Centre (TIDREC), University of Malaya , Kuala Lumpur, Malaysia
| | - Juraina Abd-Jamil
- 1 Tropical Infectious Diseases Research & Education Centre (TIDREC), University of Malaya , Kuala Lumpur, Malaysia
| | - Jing-Jing Khoo
- 1 Tropical Infectious Diseases Research & Education Centre (TIDREC), University of Malaya , Kuala Lumpur, Malaysia
| | - Hai-Yen Lee
- 1 Tropical Infectious Diseases Research & Education Centre (TIDREC), University of Malaya , Kuala Lumpur, Malaysia
| | - Brian L Pike
- 4 U.S. Naval Medical Research Center-Asia , Singapore, Singapore
| | - Li Ping Wong
- 3 Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia
| | - Yvonne Ai-Lian Lim
- 5 Department of Parasitology, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia
| | - Keivan Zandi
- 1 Tropical Infectious Diseases Research & Education Centre (TIDREC), University of Malaya , Kuala Lumpur, Malaysia .,6 Laboratory of Biochemical Pharmacology, Department of Pediatrics, Center for AIDS Research, Emory University School of Medicine , Atlanta, Georgia
| | - Sazaly AbuBakar
- 1 Tropical Infectious Diseases Research & Education Centre (TIDREC), University of Malaya , Kuala Lumpur, Malaysia .,2 Department of Medical Microbiology, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia
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