Selection of posterior fixation segments for Lenke 5 adolescent idiopathic scoliosis

Abstract

With the further understanding of the concept of three-dimensional correction by spinal surgeons, the progress of internal fixation instruments, de-rotation tools and the improvement of surgical techniques, the scientific formulation of surgical strategies for Lenke 5 adolescent idiopathic scoliosis has gradually become the focus of controversy. The formulation of preoperative surgical strategy not only directly affects the correction of deformity and balance reconstruction, but also is directly related to the activity function of spine and the quality of life of patients after operation. Therefore, this paper will discuss from three aspects: the method of surgical fixation, the surgical approach and the selection of fixed vertebrae. The author believes that Risser sign should be taken as an important consideration to judge the method of surgical fixation. The choice of surgical approach must refer to the operator's familiarity and experience with the approach, grasp the adaptive signs and consider the risks and benefits of the operation, and choose the appropriate surgical approach according to the needs of different patients. The choice of fixed vertebrae, choosing upper end vertebra (UEV) as upper instrumented vertebra (UIV), is safer than the more radical upper end vertebra-1 (UEV-1), and five factors need to be combined in the specific selection of lower instrumented vertebra (LIV).