Selective Fusion in Lenke 5 Adolescent Idiopathic Scoliosis

World Neurosurgery
Jie LiZhen Liu

Abstract

To compare the clinical and radiographic outcomes on the sagittal plane between anterior and posterior selective fusion (ASF and PSF) in patients with Lenke 5 adolescent idiopathic scoliosis (AIS) for a minimum of 5 years of follow-up. We included 77 patients with Lenke 5 AIS who underwent ASF (n = 40) with a single rod with structural cages or PSF (n = 37) with pedicle screw instrumentation. Radiographic parameters were compared preoperatively, 3 months and 2 years postoperatively, and at final follow-up. The mean follow-up duration was 93.9 ± 21.4 months in the ASF group and 80.4 ± 15.2 in the PSF group (P = 0.002). The correction rate of the coronal curve was comparable between the 2 groups at final follow-up. There was a significant time trend for lumbar lordosis (LL), thoracic kyphosis, thoracolumbar junctional kyphosis, instrumented segmental angle (ISA), proximal junctional angle, and sagittal vertical axis (P < 0.001) and significant group effects for LL (P = 0.0065) and ISA (P = 0.0325). At 3 months postoperatively, LL decreased in the ASF group and increased in the PSF group (-3.1° ± 6.6° vs. 1.3° ± 5.5° change, P = 0.002) and increased in both groups at final follow-up (2° ± 2.9° vs. 4.3° ± 4.9° change, P = 0.070). I...Continue Reading

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