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Archives of Orthopaedic and Trauma Surgery

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Open Access 01-01-2017 | Orthopaedic Surgery

Radiographic evaluation of posterior selective thoracolumbar or lumbar fusion for moderate Lenke 5C curves

Authors: Yanbin Zhang, Guanfeng Lin, Jianguo Zhang, Jianwei Guo, Shengru Wang, Yang Yang, Jianxiong Shen, Yipeng Wang

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 1/2017

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.

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Title: Radiographic evaluation of posterior selective thoracolumbar or lumbar fusion for moderate Lenke 5C curves
Authors: Yanbin Zhang
Guanfeng Lin
Jianguo Zhang
Jianwei Guo
Shengru Wang
Yang Yang
Jianxiong Shen
Yipeng Wang
Publication date: 01-01-2017
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 1/2017
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-016-2570-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Radiographic evaluation of posterior selective thoracolumbar or lumbar fusion for moderate Lenke 5C curves

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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