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European Spine Journal
Published in: European Spine Journal 6/2014

01-06-2014 | Original Article

Disagreements in surgical planning still exist between spinal surgeons in adolescent idiopathic scoliosis: a multisurgeon assessment

Authors: H. Yener Erken, Halil Burc, Gursel Saka, Mehmet Aydogan

Published in: European Spine Journal | Issue 6/2014

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Abstract

Purpose

Determining a surgical plan for the treatment of adolescent idiopathic scoliosis (AIS) can be challenging. Despite treatment recommendations and classification systems (such as the Lenke classification system) there is still no consensus on the optimal surgical plan for each curve type. The main objective of this study is to analyze the disagreements in surgical planning between spinal surgeons in AIS.

Methods

In a monthly meeting, four orthopaedic spine surgeons from different institutions analyzed a consecutive series of AIS patients. The differences in surgical plans were evaluated for each patient. The primary physician of the patient presented the case and specifically stated the Lenke type of the deformity in the presentation. We wanted to specifically document the disagreements between surgeons despite knowing the Lenke type of the deformity.

Results

One hundred consecutive AIS patients were reviewed over a 10-month period. There was a difference of at least one surgical plan from at least one surgeon in 31 of the cases; 30 of these disagreements in surgical planning were about fusion levels; 19 of these 30 disagreements were in only the upper instrumented vertebra (UIV), while seven were disagreements in only the lowest instrumented vertebra (LIV). In four cases, both the UIV and LIV levels varied.

Conclusions

There was at least one difference in surgical planning in 31 of the 100 cases (31 %). This shows that despite treatment algorithms and the Lenke classification system, disagreements in surgical planning still exist between spinal surgeons.
Literature
1.
King HA (1988) Selection of fusion levels for posterior instrumentation and fusion in idiopathic scoliosis. Orthop Clin North Am 19(2):247–255PubMed
2.
Lenke LG, Betz RR, Haher TR et al (2001) Multisurgeon assessment of surgical decision-making in adolescent idiopathic scoliosis: curve classification, operative approach, and fusion levels. Spine 26(21):2347–2353PubMedCrossRef
3.
Herring JA (2002) Tachdjian’s pediatric orthopaedics. Saunders, Philadelphia
4.
Majdouline Y, Aubin CE, Labelle H (2006) Objectives for correction and related instrumentation strategies in scoliosis surgery for Lenke curve types 2, 3 and 5. Stud Health Technol Inform 123:315–320PubMed
5.
Robitaille M, Aubin CE, Labelle H (2006) Biomechanical assessment of variable instrumentation strategies in adolescent idiopathic scoliosis: preliminary analysis of 3 patients and 6 scenarios. Stud Health Technol Inform 123:309–314PubMed
6.
Lenke LG, Edwards CC 2nd, Bridwell KH (2003) The Lenke classification of adolescent idiopathic scoliosis: how it organizes curve patterns as a template to perform selective fusions of the spine. Spine 28(20):S199–S207PubMedCrossRef
7.
Aubin CE, Labelle H, Ciolofan OC (2007) Variability of spinal instrumentation configurations in adolescent idiopathic scoliosis. Eur Spine J 16(1):57–64PubMedCentralPubMed
8.
Cote P, Kreitz BG, Cassidy JD et al (1998) A study of the diagnostic accuracy and reliability of the scoliometer and Adam’s forward bend test. Spine 23(7):796–802PubMedCrossRef
9.
Lenke LG, Betz RR, Bridwell KH et al (1998) Intraobserver and interobserver reliability of the classification of thoracic adolescent idiopathic scoliosis. J Bone Joint Surg (Am) 80(8):1097–1106
10.
King HA, Moe JH, Bradford DS et al (1983) The selection of fusion levels in thoracic idiopathic scoliosis. J Bone Joint Surg (Am) 65(9):1302–1313
11.
Cummings RJ, Loveless EA, Campbell J et al (1998) Interobserver reliability and intraobserver reproducibility of the system of King et al. for the classification of adolescent idiopathic scoliosis. J Bone Joint Surg 80(8):1107–1111PubMed
12.
Lenke LG, Betz RR, Harms J et al (2001) Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis. J Bone Joint Surg (Am) 83(8):1169–1181
13.
Niemeyer T, Wolf A, Kluba S et al (2002) Interobserver and intraobserver agreement of Lenke and King classifications for idiopathic scoliosis and the influence of level of professional training. Spine 31(18):2103–2107CrossRef
14.
Ogon M, Giesinger K, Behensky H et al (2002) Interobserver and intraobserver reliability of Lenke’s new scoliosis classification system. Spine 27(8):858–862PubMedCrossRef
15.
Newton PO, Faro FD, Lenke LG et al (2003) Factors involved the decision to perform a selective versus nonselective fusion of Lenke 1B and 1C (King-Moe II) curves in adolescent idiopathic scoliosis. Spine 28:S217–S223PubMedCrossRef
Metadata
Title
Disagreements in surgical planning still exist between spinal surgeons in adolescent idiopathic scoliosis: a multisurgeon assessment
Authors
H. Yener Erken
Halil Burc
Gursel Saka
Mehmet Aydogan
Publication date
01-06-2014
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 6/2014
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-014-3278-y

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