Yıl: 2022 Cilt: 33 Sayı: 4 Sayfa Aralığı: 124 - 128 Metin Dili: İngilizce DOI: 10.4274/jtss.galenos.2022.80299 İndeks Tarihi: 22-10-2022

MAIN CURVE CORRECTION AND SPONTANEOUS THORACIC CURVE CORRECTION AFTER SELECTIVE THORACLUMBAR/ LUMBAR FUSION IN LENKE TYPE 5C ADOLESCENT IDIOPATHIC SCOLIOSIS: UP TO 10 YEARS FOLLOW-UP

Öz:
Objective: Thoracolumbar/lumbar (TL/L) curves are a rare type of adolescent idiopathic scoliosis (AIS). Historically anterior selective fusion and posterior selective fusion provided satisfied results in terms of curve correction, maintenance of correction and spontaneous thoracic curve correction. Aim of our study was to present the results of selective posterior Cobb to Cobb TL/L fusion in patients lenke type 5c AIS patients with a single surgeon experience for up to 10 years of follow. Materials and Methods: Patients who underwent selective TL/L posterior fusion for a diagnose of Lenke type 5c AIS were retrospectively analyzed. Patients who were followed up minimum 2 years and underwent full preoperative, early postoperative and follow-up radiologic work up and last follow-up SRS22r scores were included in descriptive statistical analysis performed. Results: Fifty one patients (47 F, 4M) were included in the study. Mean age was 15 (12-17). Mean follow-up period was 84 months (24-120). The mean preoperative major TL/L curve improved to 6.3 (0-20) from 42.8 (38-71) with an 85% correction rate. The mean thoracic curve correction rate was %57. At follow main TL/L and upper thoracic curve did not show correction loss. Coronal imbalance has not been recorded. At last follow-up mean SRS22r was mean 4.3 (3.6-4.9). Conclusion: Selective TL/L posterior Cobb to Cobb fusion improves main TL/L and upper thoracic curves in AIS lenke type 5c patients and maintains long-term stability for the uninstrumented upper thoracic curve. Keywords: Adolescent idiopathic scoliosis, thoracolumbar curve, lenke type 5c curve, posterior instrumented fusion, selective thoracolumbar Cobb to Cobb fusion, spontaneous thoracic curve correction
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  • 1. Lenke LG, Betz RR, Harms J, Bridwell KH, Clements DH, Lowe TG, et al. Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis. J Bone Joint Surg Am. 2001;83:1169-81.
  • 2. Lenke LG, Betz RR, Clements D, Merola A, Haher T, Lowe T, et al. Curve prevalence of a new classification of operative adolescent idiopathic scoliosis: does classification correlate with treatment? Spine (Phila Pa 1976). 2002;27:604-11.
  • 3. Dwyer AF, Newton NC, Sherwood AA. An anterior approach to scoliosis. A preliminary report. Clin Orthop Relat Res. 1969;62:192-202.
  • 4. Shufflebarger HL, Geck MJ, Clark CE. The posterior approach for lumbar and thoracolumbar adolescent idiopathic scoliosis: posterior shortening and pedicle screws. Spine (Phila Pa 1976). 2004;29:269- 76; discussion 276.
  • 5. Okada E, Watanabe K, Pang L, Ogura Y, Takahashi Y, Hosogane N, et al. Posterior correction and fusion surgery using pedicle-screw constructs for Lenke type 5C adolescent idiopathic scoliosis: a preliminary report. Spine (Phila Pa 1976). 2015;40:25-30.
  • 6. Geck MJ, Rinella A, Hawthorne D, Macagno A, Koester L, Sides B, Lenke L, et al. Anterior Dual Rod Versus Posterior Pedicle Fixation Surgery for the Surgical Treatment in Lenke 5C Adolescent Idiopathic Scoliosis: A Multicenter, Matched Case Analysis of 42 Patients. Spine Deform. 2013;1:217-22.
  • 7. Miyanji F, Nasto LA, Bastrom T, Samdani AF, Yaszay B, Clements D, et al. A Detailed Comparative Analysis of Anterior Versus Posterior Approach to Lenke 5C Curves. Spine (Phila Pa 1976). 2018;43:E285-91.
  • 8. Wang F, Xu XM, Wei XZ, Zhu XD, Li M. Spontaneous Thoracic Curve Correction After Selective Posterior Fusion of Thoracolumbar/ Lumbar Curves in Lenke 5C Adolescent Idiopathic Scoliosis. Medicine (Baltimore). 2015;94:e1155.
  • 9. Huitema GC, Jansen RC, van Ooij A, Punt IM, van Rhijn LW. Predictability of spontaneous thoracic curve correction after anterior thoracolumbar correction and fusion in adolescent idiopathic scoliosis. A retrospective study on a consecutive series of 29 patients with a minimum follow-up of 2 years. Spine J. 2015;15:966-70.
  • 10. Schwender JD, Denis F. Coronal plane imbalance in adolescent idiopathic scoliosis with left lumbar curves exceeding 40 degrees: the role of the lumbosacral hemicurve. Spine (Phila Pa 1976). 2000;25:2358-63.
  • 11. Liu Z, Guo J, Zhu Z, Qian B, Sun X, Xu L, et al. Role of the upper and lowest instrumented vertebrae in predicting the postoperative coronal balance in Lenke 5C patients after selective posterior fusion. Eur Spine J. 2013;22:2392-8.
  • 12. Yang C, Zhao Y, Zhai X, Li J, Zhu X, Li M. Coronal balance in idiopathic scoliosis: a radiological study after posterior fusion of thoracolumbar/ lumbar curves (Lenke 5 or 6). Eur Spine J. 2017;26:1775-81.
  • 13. Shetty AP, Suresh S, Aiyer SN, Kanna R, Rajasekaran S. Radiological factors affecting post-operative global coronal balance in Lenke 5 C scoliosis. J Spine Surg. 2017;3:541-7.
  • 14. Li J, Hwang SW, Shi Z, Yan N, Yang C, Wang C, et al. Analysis of radiographic parameters relevant to the lowest instrumented vertebrae and postoperative coronal balance in Lenke 5C patients. Spine (Phila Pa 1976). 2011;36:1673-8.
  • 15. Wang Y, Bünger CE, Zhang Y, Wu C, Li H, Dahl B, et al. Lowest instrumented vertebra selection for Lenke 5C scoliosis: a minimum 2-year radiographical follow-up. Spine (Phila Pa 1976). 2013;38:E894-900.
  • 16. Sun Z, Qiu G, Zhao Y, Wang Y, Zhang J, Shen J. Lowest instrumented vertebrae selection for selective posterior fusion of moderate thoracolumbar/lumbar idiopathic scoliosis: lower-end vertebra or lower-end vertebra+1? Eur Spine J. 2014;23:1251-7.
  • 17. Kuklo TR, Potter BK, Polly DW Jr, O’Brien MF, Schroeder TM, Lenke LG. Reliability analysis for manual adolescent idiopathic scoliosis measurements. Spine (Phila Pa 1976). 2005;30:444-54.
  • 18. https://www.srs.org/professionals/SRS_outcomes/srs-22_turkish.pdf
  • 19. Chen K, Chen Y, Shao J, Zhoutian J, Wang F, Chen Z, et al. Long- Term Follow-up of Posterior Selective Thoracolumbar/Lumbar Fusion in Patients With Lenke 5C Adolescent Idiopathic Scoliosis: An Analysis of 10-Year Outcomes. Global Spine J. 2022;12:840-50.
  • 20. Ilgenfritz RM, Yaszay B, Bastrom TP, Newton PO; Harms Study Group. Lenke 1C and 5C spinal deformities fused selectively: 5-year outcomes of the uninstrumented compensatory curves. Spine (Phila Pa 1976). 2013;38:650-8.
  • 21. Senkoylu A, Luk KD, Wong YW, Cheung KM. Prognosis of spontaneous thoracic curve correction after the selective anterior fusion of thoracolumbar/lumbar (Lenke 5C) curves in idiopathic scoliosis. Spine J. 2014;14:1117-24.
  • 22. Lark RK, Yaszay B, Bastrom TP, Newton PO; Harms Study Group. Adding thoracic fusion levels in Lenke 5 curves: risks and benefits. Spine (Phila Pa 1976). 2013;38:195-200.
  • 23. Lee CS, Ha JK, Kim DG, Kim H, Hwang CJ, Lee DH, et al. The clinical importance of sacral slanting in patients with adolescent idiopathic scoliosis undergoing surgery. Spine J. 2015;15:834-40.
  • 24. Satake K, Lenke LG, Kim YJ, Bridwell KH, Blanke KM, Sides B, et al. Analysis of the lowest instrumented vertebra following anterior spinal fusion of thoracolumbar/lumbar adolescent idiopathic scoliosis: can we predict postoperative disc wedging? Spine (Phila Pa 1976). 2005;30:418-26.
  • 25. Banno T, Yamato Y, Oba H, Ohba T, Hasegawa T, Yoshida G, et al. Preoperative Thoracic Curve Magnitude and L4 End Vertebra Were Risk Factors for Subjacent Disc Wedging After Selective Thoracolumbar/ Lumbar Fusion with L3 as the Lowest Instrumented Vertebra in Lenke Type 5 Curve Patients. Spine (Phila Pa 1976). 2021;46:E878-87.
APA Kaya O, SANLI T, COSKUN H, Ulusoy O, Dincer R, Karadereler S, Enercan M, Hamzaoglu A (2022). MAIN CURVE CORRECTION AND SPONTANEOUS THORACIC CURVE CORRECTION AFTER SELECTIVE THORACLUMBAR/ LUMBAR FUSION IN LENKE TYPE 5C ADOLESCENT IDIOPATHIC SCOLIOSIS: UP TO 10 YEARS FOLLOW-UP. , 124 - 128. 10.4274/jtss.galenos.2022.80299
Chicago Kaya Ozcan,SANLI TUNAY,COSKUN Huseyin Sina,Ulusoy Onur Levent,Dincer Recep,Karadereler Selhan,Enercan Meric,Hamzaoglu Azmi MAIN CURVE CORRECTION AND SPONTANEOUS THORACIC CURVE CORRECTION AFTER SELECTIVE THORACLUMBAR/ LUMBAR FUSION IN LENKE TYPE 5C ADOLESCENT IDIOPATHIC SCOLIOSIS: UP TO 10 YEARS FOLLOW-UP. (2022): 124 - 128. 10.4274/jtss.galenos.2022.80299
MLA Kaya Ozcan,SANLI TUNAY,COSKUN Huseyin Sina,Ulusoy Onur Levent,Dincer Recep,Karadereler Selhan,Enercan Meric,Hamzaoglu Azmi MAIN CURVE CORRECTION AND SPONTANEOUS THORACIC CURVE CORRECTION AFTER SELECTIVE THORACLUMBAR/ LUMBAR FUSION IN LENKE TYPE 5C ADOLESCENT IDIOPATHIC SCOLIOSIS: UP TO 10 YEARS FOLLOW-UP. , 2022, ss.124 - 128. 10.4274/jtss.galenos.2022.80299
AMA Kaya O,SANLI T,COSKUN H,Ulusoy O,Dincer R,Karadereler S,Enercan M,Hamzaoglu A MAIN CURVE CORRECTION AND SPONTANEOUS THORACIC CURVE CORRECTION AFTER SELECTIVE THORACLUMBAR/ LUMBAR FUSION IN LENKE TYPE 5C ADOLESCENT IDIOPATHIC SCOLIOSIS: UP TO 10 YEARS FOLLOW-UP. . 2022; 124 - 128. 10.4274/jtss.galenos.2022.80299
Vancouver Kaya O,SANLI T,COSKUN H,Ulusoy O,Dincer R,Karadereler S,Enercan M,Hamzaoglu A MAIN CURVE CORRECTION AND SPONTANEOUS THORACIC CURVE CORRECTION AFTER SELECTIVE THORACLUMBAR/ LUMBAR FUSION IN LENKE TYPE 5C ADOLESCENT IDIOPATHIC SCOLIOSIS: UP TO 10 YEARS FOLLOW-UP. . 2022; 124 - 128. 10.4274/jtss.galenos.2022.80299
IEEE Kaya O,SANLI T,COSKUN H,Ulusoy O,Dincer R,Karadereler S,Enercan M,Hamzaoglu A "MAIN CURVE CORRECTION AND SPONTANEOUS THORACIC CURVE CORRECTION AFTER SELECTIVE THORACLUMBAR/ LUMBAR FUSION IN LENKE TYPE 5C ADOLESCENT IDIOPATHIC SCOLIOSIS: UP TO 10 YEARS FOLLOW-UP." , ss.124 - 128, 2022. 10.4274/jtss.galenos.2022.80299
ISNAD Kaya, Ozcan vd. "MAIN CURVE CORRECTION AND SPONTANEOUS THORACIC CURVE CORRECTION AFTER SELECTIVE THORACLUMBAR/ LUMBAR FUSION IN LENKE TYPE 5C ADOLESCENT IDIOPATHIC SCOLIOSIS: UP TO 10 YEARS FOLLOW-UP". (2022), 124-128. https://doi.org/10.4274/jtss.galenos.2022.80299
APA Kaya O, SANLI T, COSKUN H, Ulusoy O, Dincer R, Karadereler S, Enercan M, Hamzaoglu A (2022). MAIN CURVE CORRECTION AND SPONTANEOUS THORACIC CURVE CORRECTION AFTER SELECTIVE THORACLUMBAR/ LUMBAR FUSION IN LENKE TYPE 5C ADOLESCENT IDIOPATHIC SCOLIOSIS: UP TO 10 YEARS FOLLOW-UP. Journal of Turkish Spinal Surgery, 33(4), 124 - 128. 10.4274/jtss.galenos.2022.80299
Chicago Kaya Ozcan,SANLI TUNAY,COSKUN Huseyin Sina,Ulusoy Onur Levent,Dincer Recep,Karadereler Selhan,Enercan Meric,Hamzaoglu Azmi MAIN CURVE CORRECTION AND SPONTANEOUS THORACIC CURVE CORRECTION AFTER SELECTIVE THORACLUMBAR/ LUMBAR FUSION IN LENKE TYPE 5C ADOLESCENT IDIOPATHIC SCOLIOSIS: UP TO 10 YEARS FOLLOW-UP. Journal of Turkish Spinal Surgery 33, no.4 (2022): 124 - 128. 10.4274/jtss.galenos.2022.80299
MLA Kaya Ozcan,SANLI TUNAY,COSKUN Huseyin Sina,Ulusoy Onur Levent,Dincer Recep,Karadereler Selhan,Enercan Meric,Hamzaoglu Azmi MAIN CURVE CORRECTION AND SPONTANEOUS THORACIC CURVE CORRECTION AFTER SELECTIVE THORACLUMBAR/ LUMBAR FUSION IN LENKE TYPE 5C ADOLESCENT IDIOPATHIC SCOLIOSIS: UP TO 10 YEARS FOLLOW-UP. Journal of Turkish Spinal Surgery, vol.33, no.4, 2022, ss.124 - 128. 10.4274/jtss.galenos.2022.80299
AMA Kaya O,SANLI T,COSKUN H,Ulusoy O,Dincer R,Karadereler S,Enercan M,Hamzaoglu A MAIN CURVE CORRECTION AND SPONTANEOUS THORACIC CURVE CORRECTION AFTER SELECTIVE THORACLUMBAR/ LUMBAR FUSION IN LENKE TYPE 5C ADOLESCENT IDIOPATHIC SCOLIOSIS: UP TO 10 YEARS FOLLOW-UP. Journal of Turkish Spinal Surgery. 2022; 33(4): 124 - 128. 10.4274/jtss.galenos.2022.80299
Vancouver Kaya O,SANLI T,COSKUN H,Ulusoy O,Dincer R,Karadereler S,Enercan M,Hamzaoglu A MAIN CURVE CORRECTION AND SPONTANEOUS THORACIC CURVE CORRECTION AFTER SELECTIVE THORACLUMBAR/ LUMBAR FUSION IN LENKE TYPE 5C ADOLESCENT IDIOPATHIC SCOLIOSIS: UP TO 10 YEARS FOLLOW-UP. Journal of Turkish Spinal Surgery. 2022; 33(4): 124 - 128. 10.4274/jtss.galenos.2022.80299
IEEE Kaya O,SANLI T,COSKUN H,Ulusoy O,Dincer R,Karadereler S,Enercan M,Hamzaoglu A "MAIN CURVE CORRECTION AND SPONTANEOUS THORACIC CURVE CORRECTION AFTER SELECTIVE THORACLUMBAR/ LUMBAR FUSION IN LENKE TYPE 5C ADOLESCENT IDIOPATHIC SCOLIOSIS: UP TO 10 YEARS FOLLOW-UP." Journal of Turkish Spinal Surgery, 33, ss.124 - 128, 2022. 10.4274/jtss.galenos.2022.80299
ISNAD Kaya, Ozcan vd. "MAIN CURVE CORRECTION AND SPONTANEOUS THORACIC CURVE CORRECTION AFTER SELECTIVE THORACLUMBAR/ LUMBAR FUSION IN LENKE TYPE 5C ADOLESCENT IDIOPATHIC SCOLIOSIS: UP TO 10 YEARS FOLLOW-UP". Journal of Turkish Spinal Surgery 33/4 (2022), 124-128. https://doi.org/10.4274/jtss.galenos.2022.80299