Does fusion to T2 compared with T3/T4 lead to improved shoulder balance in adolescent idiopathic scoliosis with a double thoracic curve?

Journal of Pediatric Orthopedics. Part B
Choon Sung LeeJae Hwan Cho

Abstract

Proximal fusion level selection in adolescent idiopathic scoliosis (AIS) with a double thoracic curve (Lenke-2) remains debatable. The aim of this study was to compare the radiological outcomes of corrective surgery for Lenke-2 AIS according to the upper instrumented vertebra (UIV). This study included 74 patients who underwent corrective surgery for Lenke-2 AIS with the right main thoracic and left proximal thoracic (PT) curve at a single center. Various radiological parameters were measured using whole-spine standing radiographs preoperatively and postoperatively. Patients were grouped by proximal fusion level: T2 (group F; fusion, N=15) or T3/T4 (group NF; nonfusion, N=59). Preoperative and postoperative radiological parameters were compared between the two groups. Group NF was divided on the basis of the existence of a postoperative shoulder imbalance (PSI; >15 mm) and a subgroup analysis was carried out. PT curve correction rate (58.5 vs. 46.3%, P=0.005), right shoulder depression (4.3 vs. 10.3 mm, P=0.020), and proximal adjacent wedging (1.1 vs. 3.5°, P<0.001) were different between groups F and NF postoperatively. In the subgroup analysis, the Risser grade (3.9 vs. 2.8, P=0.009) and the main thoracic curve flexibility (5...Continue Reading

References

Feb 8, 2007·Journal of Spinal Disorders & Techniques·Choon-Sung LeeDong-Ho Lee
Oct 20, 2007·The Orthopedic Clinics of North America·Peter S Rose, Lawrence G Lenke
Dec 2, 2008·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Xu-sheng QiuYong Qiu
Sep 3, 2013·The Journal of the American Academy of Orthopaedic Surgeons·Per David TrobischThomas J Errico
Mar 26, 2014·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·H Yener ErkenMehmet Aydogan
Mar 17, 2016·HSS Journal : the Musculoskeletal Journal of Hospital for Special Surgery·Benjamin T BjerkeMatthew E Cunningham

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