Comparative study of effect of reliability between Lenke and PUMC classification systems for adolescent idiopathic scoliosis upon surgical fusion range.

Abstract

Objective To compare the effect of reliability between Lenke and Peking Union Medi-cal College (PUMC) classification systems for Adolescent Idiopathic Scoliosis (AIS) upon surgical fusion range. Methods 62 scoliosis cases were classificated according to Lenke classification system and PUMC classification system by 5 spine surgeons, and each case was done twice. The reliability and consistency be-tween the two classification systems were investigated and evaluated. Results The reliability and consis-tency were good-to-excellent in the curve type parameter of Lenke classification system and PUMC classifi-cation system. According to Lenke curve type classification, there were 24 cases of disagreements, 2 cases of them without effection to bone fusion. According PUMC classification, there were 17 cases of disagreements, 7 of them without effection to fnsio. In the 24 Lenke disagreemrnt cases, 14 cases had the consistency result according to PUMC classification; while in 17 PUMC disagreement cases, 7 cases had the consistency result according to Lenke curve type classification. There were good coherence between the two classification sys-tems. 24 Lenke disagreement cases categorized according to PUMC classification, 19 cases did not affect fu-sion range; while 17 PUMC disagreements cases placed under Lenke curve type classification only 9 cases did not affect fusion level. There were no significant difference. Conclusion In Lenke classification system curve type parameter determines fusion levels, sharing good-to-excellent reliability to the PUMC classifica-tion. However the PUMC classification is simpler in use, with fewer disagreements, as well as nearly half of disagreement cases not affecting fusion levels selection. Key words: Scoliosis; Classification; Spinal fusion