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- Title
Influence of Lateral Translation of Lowest Instrumented Vertebra on L4 Tilt and Coronal Balance for Thoracolumbar and Lumbar Curves in Adolescent Idiopathic Scoliosis.
- Authors
Yamada, Katsuhisa; Sudo, Hideki; Abe, Yuichiro; Kokabu, Terufumi; Tachi, Hiroyuki; Endo, Tsutomu; Ohnishi, Takashi; Ukeba, Daisuke; Ura, Katsuro; Takahata, Masahiko; Iwasaki, Norimasa
- Abstract
This study aimed to evaluate the lowest instrumented vertebra translation (LIV-T) in the surgical treatment of thoracolumbar/lumbar adolescent idiopathic scoliosis and to analyze the radiographic parameters in relation to LIV-T and L4 tilt and global coronal balance. A total of 62 patients underwent posterior spinal fusion (PSF, n = 32) or anterior spinal fusion (ASF, n = 30) and were followed up for a minimum of 2 years. The mean preoperative LIV-T was significantly larger in the ASF group than the PSF (p < 0.01), while the final LIV-T was equivalent. LIV-T at the final follow-up was significantly correlated with L4 tilt and the global coronal balance (r = 0.69, p < 0.01, r = 0.38, p < 0.01, respectively). Receiver-operating characteristic analysis for good outcomes, with L4 tilt <8° and coronal balance <15 mm at the final follow-up, calculated the cutoff value of the final LIV-T as 12 mm. The cutoff value of preoperative LIV-T that would result in the LIV-T of ≤12 mm at the final follow-up was 32 mm in PSF, although no significant cutoff value was calculated in ASF. ASF can centralize the LIV better than PSF with a shorter segment fusion, and could be useful in obtaining a good curve correction and global balance without fixation to L4 in cases with large preoperative LIV-T.
- Subjects
ADOLESCENT idiopathic scoliosis; ORTHOPEDIC braces; SPINAL fusion; VERTEBRAE; LUMBAR vertebrae; REFERENCE values
- Publication
Journal of Clinical Medicine, 2023, Vol 12, Issue 4, p1389
- ISSN
2077-0383
- Publication type
Article
- DOI
10.3390/jcm12041389