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

Abstract

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