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Radiographic evaluation of posterior selective thoracolumbar or lumbar fusion for moderate Lenke 5C curves
- Source :
- Archives of Orthopaedic and Trauma Surgery
- Publisher :
- Springer Nature
-
Abstract
- Introduction Posterior selective thoracolumbar or lumbar (TL/L) fusion with pedicle screw constructs for adolescent idiopathic scoliosis (AIS) has been studied in a few researches. However, few studies have discussed the indication for selective TL/L fusion and the behaviors of its adjacent disc angle. The present study aims to discuss the indication for posterior selective TL/L fusion and the behavior of the adjacent disc angle. Methods 45 consecutive cases of AIS undergoing posterior selective TL/L fusion were retrospectively evaluated, with an average follow-up of 36 months. Radiographs were reviewed to determine the coronal curve magnitude and the sagittal alignment preoperatively, postoperatively and at final follow-up. Thoracic curves in groups A had a correction loss of more than 5°, while thoracic curves in group B had a correction loss of not more than 5°. Results The coronal curve magnitude of the TL/L curve averaged 44° preoperatively and it was corrected to 6° immediately with a correction rate of 84.8 %. At final follow-up it was 9° with a correction loss of 3°. The minor thoracic curve was 26° preoperatively, and the convex side bending curve magnitude averaged 8° with a flexibility of 72.7 %. It was corrected to 13° immediately with a spontaneous correction of 48.5 %. At final follow-up it was 14° with a correction loss of 1°. UIVA decreased from 4° to 2° after surgery, and it was 2° at final follow-up. LIVA decreased from 7° to 4° after surgery, and it was 5° at final follow-up. Maximal correction of TL/L curves in group A is significantly less than that in group B. 1 patient received revision surgery to fuse the progressive thoracic curve. Conclusion Posterior selective TL/L fusion with pedicle screw constructs allows for spontaneous thoracic correction and maintains coronal and sagittal balance during the follow-up. Maximal correction instead of undercorrection was recommended for moderate Lenke 5C curves. Disc wedging could be improved after surgery and well maintained during the follow-up.
- Subjects :
- Male
Reoperation
musculoskeletal diseases
medicine.medical_specialty
Thoracolumbar or lumbar
Maximal correction
Adolescent
Radiography
Idiopathic scoliosis
Selective fusion
Thoracic Vertebrae
Young Adult
03 medical and health sciences
0302 clinical medicine
Lumbar
Pedicle Screws
medicine
Humans
Orthopedics and Sports Medicine
Child
Pedicle screw
Retrospective Studies
030222 orthopedics
Fusion
Lumbar Vertebrae
business.industry
General Medicine
Orthopaedic Surgery
Surgery
Indication
Spinal Fusion
Treatment Outcome
Scoliosis
Disc wedging
Orthopedic surgery
Female
business
Nuclear medicine
030217 neurology & neurosurgery
Subjects
Details
- Language :
- English
- ISSN :
- 09368051
- Volume :
- 137
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Archives of Orthopaedic and Trauma Surgery
- Accession number :
- edsair.doi.dedup.....22e5397015b8f1bfb14d325f32db4af7
- Full Text :
- https://doi.org/10.1007/s00402-016-2570-1