The benefits of touched vertebra concept for the selection of the lowest instrumented vertebra in thoracic curves of adolescent idiopathic scoliosis.

IF 2.6 3区医学 Q2 CLINICAL NEUROLOGY

European Spine Journal Pub Date : 2024-12-05 DOI:10.1007/s00586-024-08597-9

Dong-Gune Chang, Lawrence G Lenke, Hong Jin Kim, Javier Pizones, René Castelein, Per D Trobisch, Kota Watanabe, Kee-Yong Ha, Se-Il Suk

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引用次数: 0

Abstract

Purpose: To assess the benefits of using the touched vertebra (TV) rule in Lenke classification for thoracic curves of adolescent idiopathic scoliosis (AIS).

Methods: A total of 141 AIS patients with thoracic curves determined by Suk classification were divided based on whether the lowest instrumented vertebra (LIV) matched the TV into groups of mTV (n = 84, LIV = TV), TV- (n = 21, LIV above TV), and TV+ (n = 36, LIV below TV) for 5-year follow-up. The radiological parameters were the central sacral vertical line (CSVL)-LIV distance, distal end vertebra rotation, coronal, and sagittal parameters. Complications included adding-on phenomenon, coronal imbalance, and distal junctional kyphosis.

Results: Adding-on phenomenon and coronal imbalance were significantly higher in the TV- group (P = 0.006) and TV + group (P = 0.006), respectively. The distal motion segments were significantly saved in the mTV group (P < 0.001). The CSVL-LIV distance was significantly improved in the mTV group compared to the others during the 5-year follow-up (P = 0.007). The 5-year follow-up CSVL-LIV distance correlated with LIV tilt angle (r = 0.442, P = 0.021) and coronal balance (r = 0.437, P = 0.023).

Conclusions: Selecting the TV as LIV minimizes the loss of the distal mobile segment and reduces the complications in the thoracic curves of AIS, which produces a more stable LIV on the CSVL. Therefore, TV is an ideal landmark for determining the distal fusion level using the Lenke classification or Suk classification.

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来源期刊

European Spine Journal 医学-临床神经学

CiteScore

4.80

自引率

10.70%

发文量

373

审稿时长

2-4 weeks

期刊介绍： "European Spine Journal" is a publication founded in response to the increasing trend toward specialization in spinal surgery and spinal pathology in general. The Journal is devoted to all spine related disciplines, including functional and surgical anatomy of the spine, biomechanics and pathophysiology, diagnostic procedures, and neurology, surgery and outcomes. The aim of "European Spine Journal" is to support the further development of highly innovative spine treatments including but not restricted to surgery and to provide an integrated and balanced view of diagnostic, research and treatment procedures as well as outcomes that will enhance effective collaboration among specialists worldwide. The “European Spine Journal” also participates in education by means of videos, interactive meetings and the endorsement of educative efforts. Official publication of EUROSPINE, The Spine Society of Europe