Study Design: Retrospective radiographical review.
Objective: To demonstrate that the structural and noncompensatory Lenke 3 and 4C lumbar curves could be nonstructural and compensatory.
Summary Of Background Data: Historically, Lenke 3 and 4C curves were not recommended for selective thoracic fusion (STF) because the lumbar curve was considered structural and noncompensatory. However, consecutive series of Lenke 3 and 4C curves suggest successful treatment with STF.
Methods: Between 2001 and 2004, 2005 and 2008, and 2010 and 2012, 3 consecutive series of 108, 134, and 78 surgically treated Lenke 1, 2, 3, and 4C curves were reviewed, respectively. The coronal curve criteria for the curves treated with STF during each period were lumbar side bending Cobb angle less than 25° and meeting the Lenke ratio criteria, lumbar side bending Cobb angle 35° or less, and lumbar side bending Cobb angle 45° or less, respectively. The sagittal curve criteria for STF during each period was absence of junctional thoracolumbar kyphosis 20° or more between T10 and L2. The technique used for STF was the Guan-Din method. Radiographs of all the curves treated with STF were analyzed before and after surgery.
Results: Optimal instrumented thoracic and compensatory lumbar correction was obtained for all Lenke 1, 2, 3, and 4C curves treated with STF in each period. As the coronal criteria for STF were broadened, the extent of feasibility of STF was expanded and the rate of STF increased. Although Cobb angle, apical vertebral translation, and apical vertebral rotation magnitudes of Lenke 3 and 4C curves were larger and more severe than those of Lenke 1 and 2C curves, optimal compensatory correction could still be obtained for Lenke 3 and 4C curves.
Conclusion: The structural and noncompensatory Lenke 3 and 4C lumbar curves were proven to be nonstructural and compensatory. Lenke 1, 2, 3, and 4C curves have similar natures and similar responses to the same technique (Guan-Din method) used for STF and could be considered collectively as a single indication for STF. The extent of feasibility of STF could be expanded from Lenke 1 and 2 curves to Lenke 1, 2, 3, and 4 curves.
Level Of Evidence: 2.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1097/BRS.0000000000000535 | DOI Listing |
J Bone Joint Surg Am
November 2024
Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY.
Background: An accurate knowledge of a patient's risk of cord-level intraoperative neuromonitoring (IONM) data loss is important for an informed decision-making process prior to deformity correction, but no prediction tool currently exists.
Methods: A total of 1,106 patients with spinal deformity and 205 perioperative variables were included. A stepwise machine-learning (ML) approach using random forest (RF) analysis and multivariable logistic regression was performed.
Eur Spine J
January 2025
Center for Musculoskeletal Surgery, Charité- Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Purpose: Although idiopathic scoliosis is a common three-dimensional deformity, there is a lack of studies evaluating the associations between the aortic-vertebral distance (AVD) and spinal deformities in all planes. The study therefore aimed to evaluate how the coronal and sagittal curvature, vertebral rotation and aortic-vertebral angle (AVA) affect the AVD in idiopathic scoliosis.
Methods: The AVD, AVA, vertebral rotation and curve angles were measured on preoperative magnetic resonance imaging and radiographs in 46 patients who underwent posterior spinal fusion with pedicle screw instrumentation for idiopathic scoliosis Lenke types 1 and 2.
Spine Deform
January 2025
Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline Street, JHOC 5223, Baltimore, MD, 21287, USA.
Purpose: Few studies have investigated quality-of-life (QoL)-related outcome measures in adolescent idiopathic scoliosis (AIS) patients over long-term follow-up. We investigated whether patients with any given Lenke type improved relative to other types and whether selective fusions resulted in better QoL-related outcome measures.
Methods: We utilized the Harms Study Group database to select patients with AIS who underwent posterior spinal fusion (PSF) with Scoliosis Research Society questionnaire-22 revised (SRS-22r) scores at minimum 10-year follow-up.
Asian Spine J
December 2024
Department of Spine Surgery and Orthopaedics, Xiangya Hospital of Central South University, Changsha, China.
Study Design: A retrospective study.
Purpose: This study aimed to compare the clinical effectiveness of en-bloc direct vertebrae rotation (DVR) to non-DVR for the correction of Lenke 5C.
Overview Of Literature: The primary goal of posterior correction is to preserve the lumbar spine and achieve a well-balanced spine.
Acta Neurochir (Wien)
January 2025
Department of Orthopaedics & Traumatology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
Background: The aim of this study is to examine the association between adding-on (AO) and disc degeneration(DD) of distal unfused levels in Lenke 3 C, 5 C, 6 C adolescent idiopathic scoliosis (AIS) patients with a follow-up of at least two years by comparing preoperative and postoperative magnetic resonance imaging (MRI).
Methods: 47 AIS patients (32 females and 15 males) with structural thoracolumbar/lumbar (TL/L) curves treated with long segment thoracolumbar fusion were retrospectively evaluated. Patients were divided into two groups according to the occurrence of the AO (AO and Non-AO groups).
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!