Abstract
ABSTRACT Objective To evaluate coronal alignment in patients with idiopathic adolescent scoliosis with structured lumbar curves submitted to surgical treatment by comparing coronal alignment in the group fusion up to L3 and the group fusion up to L4. Methods Retrospective cohort study. We evaluated patients submitted to surgical treatment with arthrodesis of the lumbar curve with high density of screws with at least 6 months of follow-up. Radiographically, coronal alignment, shoulder height and functional outcome were analyzed through SRS30 questionnaire. Results A total of 25 patients were analyzed, of which 23 were female and 2 were male, with a mean age of 15.2 years (12 to 29 years) at the time of surgery. The patients were divided into two groups. Group A, n = 15: Distal level of fusion in L3 and Group B, n = 10: distal level of fusion in L4. There was no statistically significant difference between Groups A and B when compared to coronal alignment (balanced vs. unbalanced). However, when compared with the coronal alignment (CA) values, lower values of CA were observed in Group A, with statistical significance. No difference was observed between Groups A and B with respect to the SRS30 questionnaire. Conclusions Patients with idiopathic adolescent scoliosis submitted to arthrodesis of the lumbar curve have a better coronal alignment when the distal fusion level is L3. Level of evidence III; Comparative Retrospective Study (based on prospectively collected data).
Highlights
The definition of the arthrodesis level is the most important individual factor in the postoperative outcome of corrective idiopathic scoliosis surgery.[1]
We evaluated patients submitted to surgical treatment with arthrodesis of the lumbar curve with high density of screws with at least 6 months of follow-up
Suk proposed a classification that defines the distal level of the lumbar arthrodesis according to the rotation and translation of L3 in tilt radiographs,[1] there is no consensus around the ideal distal level
Summary
The definition of the arthrodesis level is the most important individual factor in the postoperative outcome of corrective idiopathic scoliosis surgery.[1] Historically, fusion criteria have been evolving over the years, accompanied by changes in spinal correction techniques and instrumentation.[2]. Lenke popularized the concept of the touched vertebra (TV) as the appropriate arthrodesis level for some curves. The term substantially touched vertebra (STV) was later defined as the first vertebra touched by the medial sacral line since touching the pedicle.[7] At the same time, Suk proposed a classification that defines the distal level of the lumbar arthrodesis according to the rotation and translation of L3 in tilt radiographs,[1] there is no consensus around the ideal distal level
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