Abstract
BackgroundAlthough Lenke classification analyses the sagittal plane as (+), N, and (-), it does not consider it in the choice of treatment, and it has limitations with overall thoracic kyphosis (TK). To investigate the importance of TK for treatment preference in patients with Lenke 5C adolescent idiopathic scoliosis (AIS) by comparing radiological outcomes of the patients who underwent selective fusion (SF) or nonselective fusion (NSF). MethodsThirty-two patients with Lenke type 5C AIS were included and then divided into two groups as per the fusion procedure used in the surgical treatment. SF group including 17 patients (15 females; mean age = 16 years, age range, 14–21) with normal TK and NSF group including 15 patients (11 females; mean age = 17 years, age range, 13–26) with thoracic hyper-kyphosis. Thorocolumbar/lumbar (TL/L) Cobb, thoracic (T) Cobb, TK and lumbar lordosis (LL) were measured on standing spine radiographs preoperatively and at the final follow-up. The correction rates (CR) of each radiographic parameter were calculated.ResultsNo significant differences were observed in the mean CR of all radiographic parameters, except TK and LL correction rates. The mean CR of TK was significantly higher in NSF group (-17% [range, -100–69]) than in SF group (67% [range, 9–100]) (p = 0.000). Likewise, the mean CR of LL was found significantly higher in NSF group (12.47% [range, -100–51]) than in SF group (-2.41% [range, -75–47]) (p = 0.036).ConclusionIn patients in whom Lenke's sagittal modifier is N, SF can be performed efficiently. NSF should be preferred in those with Lenke's sagittal modifiers (+) as TK can be better controlled with NSF.Level of Evidence: 3
Influence of adolescent idiopathic scoliosis on dynamical strategies in the sagittal plane
