TY - JOUR
T1 - Lowest instrumented vertebra selection for Lenke 5C scoliosis
AU - Wang, Yu
AU - Bünger, Cody Eric
AU - Zhang, Yanqun
AU - Wu, Chunsen
AU - Li, Haisheng
AU - Dahl, Benny
AU - Hansen, Ebbe Stender
PY - 2013/6/15
Y1 - 2013/6/15
N2 - Study Design. A radiographical follow-up and analysis. Objective. To investigate the postoperative curve change in Lenke 5C scoliosis, and to discuss how to select lowest instrumented vertebra (LIV). Summary of Background Data. 5C curves are relatively rare in adolescent idiopathic scoliosis, and few studies have focused on this type of adolescent idiopathic scoliosis. Such questions as "How does the curve change over time in the postoperative period?" "Is LIV selection correlated with fi nal correction and balance?" and "How should we select LIV for Lenke 5C curves?" need to be answered. Methods. We reviewed all the adolescent idiopathic scoliosis cases surgically treated in an institution from 2002 through 2008. Inclusion criteria were as follows: (1) patients with Lenke 5C curves who were treated with selective lumbar fusion; (2) minimum 2-year radiographical follow-up. All image data were available and all measurements were performed in picture archiving and communication systems. Standing posteroanterior and lateral digital radiographs were reviewed at 4 junctures: preoperative, immediate postoperative, 3 months, and 2 years postoperatively. Results. Thirty patients met the inclusion criteria. The following results were observed: (1) From the perspectives of both Cobb angle and vertebral translation, signifi cant correction was achieved; (2) The correction obtained by surgery was well retained in the postoperative period; (3) Although preoperative spinal imbalance was common in this group of patients, the majority eventually attained balance at 2 years; (4) LIV selection was signifi cantly correlated with the 2-year correction and balance; (5) In the literature as well as in this study, the overall preoperative LIV-center sacral vertical line distance is 28 mm and the overall preoperative LIV tilt is 25°. Conclusion. In Lenke 5C scoliosis, preoperative spinal imbalance is common, although the majority of patients attain balance at 2 years. Signifi cant correction loss is not common in the postoperative period. LIV selection signifi cantly correlates with 2-year correction and balance. A translation of 28 mm and a tilt of 25° may be used as a general criterion for selecting LIV.
AB - Study Design. A radiographical follow-up and analysis. Objective. To investigate the postoperative curve change in Lenke 5C scoliosis, and to discuss how to select lowest instrumented vertebra (LIV). Summary of Background Data. 5C curves are relatively rare in adolescent idiopathic scoliosis, and few studies have focused on this type of adolescent idiopathic scoliosis. Such questions as "How does the curve change over time in the postoperative period?" "Is LIV selection correlated with fi nal correction and balance?" and "How should we select LIV for Lenke 5C curves?" need to be answered. Methods. We reviewed all the adolescent idiopathic scoliosis cases surgically treated in an institution from 2002 through 2008. Inclusion criteria were as follows: (1) patients with Lenke 5C curves who were treated with selective lumbar fusion; (2) minimum 2-year radiographical follow-up. All image data were available and all measurements were performed in picture archiving and communication systems. Standing posteroanterior and lateral digital radiographs were reviewed at 4 junctures: preoperative, immediate postoperative, 3 months, and 2 years postoperatively. Results. Thirty patients met the inclusion criteria. The following results were observed: (1) From the perspectives of both Cobb angle and vertebral translation, signifi cant correction was achieved; (2) The correction obtained by surgery was well retained in the postoperative period; (3) Although preoperative spinal imbalance was common in this group of patients, the majority eventually attained balance at 2 years; (4) LIV selection was signifi cantly correlated with the 2-year correction and balance; (5) In the literature as well as in this study, the overall preoperative LIV-center sacral vertical line distance is 28 mm and the overall preoperative LIV tilt is 25°. Conclusion. In Lenke 5C scoliosis, preoperative spinal imbalance is common, although the majority of patients attain balance at 2 years. Signifi cant correction loss is not common in the postoperative period. LIV selection signifi cantly correlates with 2-year correction and balance. A translation of 28 mm and a tilt of 25° may be used as a general criterion for selecting LIV.
U2 - 10.1097/brs.0b013e31829537be
DO - 10.1097/brs.0b013e31829537be
M3 - Journal article
SN - 0362-2436
VL - 38
SP - E894-E900
JO - Spine
JF - Spine
IS - 14
ER -