Research Day
SELECTIVE THORACIC FUSION IN ADOLESCENT IDIOPATHIC SCOLIOSIS LENKE 1 AND 2 CURVE PATTERNS
Document Type
Abstract
Date
2021
Abstract
Background: The Lenke classification informs surgical planning in adolescent idiopathic scoliosis (AIS) by separating structural inflexible curves from nonstructural, flexible, compensatory curves. Lenke 1 and 2 patterns include structural thoracic curves and nonstructural lumbar curves. In selective thoracic fusion (STF), only the thoracic curve(s) are instrumented allowing the lumbar curve to spontaneously adjust to the correction of the thoracic curve. Surgeons must consider a balance between stability and mobility in choosing which vertebral levels to fuse.
Objective: Describe rate of achievement of published optimal radiographic outcomes following STF. Methods: The WMed orthopaedic spine surgery database was queried for surgically-treated patients with Lenke 1 and 2 AIS. Deidentified data including surgical information and radiographic measurements were analyzed.
Results: 3/10 (30%) patients met all 4 criteria for optimal radiographic outcome, including 0/1 (0%) treated with nonselective fusion and 3/9 (33%) treated with STF. All patients achieved lumbar cobb angle <26 ̊. 7/10 (70%) achieved coronal balance within 2cm (7/9 STF). Deformity-flexibility-quotient<4 was achieved in 5/9 (56%) STF patients. Lumbar correction >37% was attained in 7/10 (70%), 1/1 Nonselective and 6/9 (67%) STF. The STF patients that achieved all 4 optimal radiographic outcomes did so an average of 25 days following surgery.
Discussion: Short-term follow up of this small cohort demonstrated achievement of optimal radiographic outcomes in the majority of patients treated with STF, however only 30% met all 4 criteria. Further investigation is needed to determine the clinical and patient reported outcomes associated with both ideal and suboptimal radiographic parameters.