Surgical strategy of lowest instrumented vertebrae selection of anterior correction for adolescent idiopathic scoliosis / 中国矫形外科杂志

ABSTRACT

[Objective]To investigate surgical strategy of lowest instrumented vertebrae(LIV)selection of anterior correction for adolescent idiopathic scoliosis,and to discuss correlation of lowest instrumented vertebrae and trunk balance.[Method]Twenty-eight patients with thoracolumbar/lumbar adolescent idiopathic scoliosis(Lenke 5 type)were treated by anterior correction and fusion with mean 1.5-year follow-up.Specific radiographic parameters such as LIV and fusion levels,disc wedging,LIV obliquity,global coronal balance were observed respectively,and correlation of disc wedging and these parameters was analyzed.[Result]The preoperative disc angle was(2.96??1.43?)and postoperative was(-3.60??1.75?).The postoperative disc wedging was most correlated with LIV obliquity.Trunk balance and LIV-CSVL distance,fusion segments,LIV obliquity were significant correlated.[Conclusion]Selection of LIV was correlated with various radiographic parameters.Short fusion was inappropriate in such conditionsbig disc angle of lower end vertebrae between superior vertebrae,fewer vertebra between certain vertebrae and apex vertebrae,long distance from certain vertebrae to CSVL and lager obliquity of the vertebrae.Disc wedging distal to LIV tent to occur postoperatively if parallel disc was not involved.