Impact of preoperative lumbosacral takeoff flexibility on postoperative correction following spinal fusion for adolescent idiopathic scoliosis: a new consideration for selective thoracic fusion.

IF 1.6 Q3 CLINICAL NEUROLOGY

Spine deformity Pub Date : 2025-03-13 DOI:10.1007/s43390-025-01063-6

Richard E Campbell, Theodore Rudic, Alexander Hafey, Elizabeth Driskill, Peter O Newton, Keith R Bachmann

{"title":"Impact of preoperative lumbosacral takeoff flexibility on postoperative correction following spinal fusion for adolescent idiopathic scoliosis: a new consideration for selective thoracic fusion.","authors":"Richard E Campbell, Theodore Rudic, Alexander Hafey, Elizabeth Driskill, Peter O Newton, Keith R Bachmann","doi":"10.1007/s43390-025-01063-6","DOIUrl":null,"url":null,"abstract":"Purpose: Nonselective fusion for adolescent idiopathic scoliosis results in greater correction of the Lumbosacral Takeoff Angle (LSTOA); however, there are patients selectively fused that still have considerable change in their LSTOA. We sought to identify the relationship between preoperative LSTOA flexibility and postoperative correction of the LSTOA.Methods: This was a retrospective analysis of Lenke 1-6, lumbar B and C modifier patients in the Harms Study Group with 2-year follow-up. Only patients with a lumbar Cobb angle ≥ 38 and ≤ 56 were included. The cases were divided into selective (SF: 177) and nonselective fusions (NSF: 324). Multivariate regression analysis was used to identify independent preoperative factors associated with postoperative LSTOA, and postoperative LSTOA correction in the NSF and SF groups.Results: The mean postoperative LSTOA correction was 6.1 ± 3.8, with 75 (15%) patients experiencing postoperative worsening of their LSTOA. Among other variables, larger LSTOA (p < 0.001) and smaller bending LSTOA correction (p < 0.001) were predictors of larger postoperative LSTOAs in both groups. Among other variables, larger LSTOA (p < 0.001), and larger bending LSTOA correction (p < 0.01) were predictors of greater LSOTA correction in both groups. Satisfactory LSTOA correction in the selective fusion group was associated with larger preoperative LSTOA (p < 0.001), larger bending LSTOA correction (p < 0.001), larger lumbar Cobb angle bending correction (p: 0.034), and smaller lumbar apex to LIV distance (p: 0.003).Conclusions: Preoperative static and bending LSTOA measurements may help surgeons decide between selective and non-selective fusion in patients with AIS.Level of evidence: 3: ","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Spine deformity","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s43390-025-01063-6","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: Nonselective fusion for adolescent idiopathic scoliosis results in greater correction of the Lumbosacral Takeoff Angle (LSTOA); however, there are patients selectively fused that still have considerable change in their LSTOA. We sought to identify the relationship between preoperative LSTOA flexibility and postoperative correction of the LSTOA.

Methods: This was a retrospective analysis of Lenke 1-6, lumbar B and C modifier patients in the Harms Study Group with 2-year follow-up. Only patients with a lumbar Cobb angle ≥ 38 and ≤ 56 were included. The cases were divided into selective (SF: 177) and nonselective fusions (NSF: 324). Multivariate regression analysis was used to identify independent preoperative factors associated with postoperative LSTOA, and postoperative LSTOA correction in the NSF and SF groups.

Results: The mean postoperative LSTOA correction was 6.1 ± 3.8, with 75 (15%) patients experiencing postoperative worsening of their LSTOA. Among other variables, larger LSTOA (p < 0.001) and smaller bending LSTOA correction (p < 0.001) were predictors of larger postoperative LSTOAs in both groups. Among other variables, larger LSTOA (p < 0.001), and larger bending LSTOA correction (p < 0.01) were predictors of greater LSOTA correction in both groups. Satisfactory LSTOA correction in the selective fusion group was associated with larger preoperative LSTOA (p < 0.001), larger bending LSTOA correction (p < 0.001), larger lumbar Cobb angle bending correction (p: 0.034), and smaller lumbar apex to LIV distance (p: 0.003).

Conclusions: Preoperative static and bending LSTOA measurements may help surgeons decide between selective and non-selective fusion in patients with AIS.

Level of evidence: 3:

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

Spine deformity

CiteScore

3.20

自引率

18.80%

发文量

167

期刊介绍： Spine Deformity the official journal of the?Scoliosis Research Society is a peer-refereed publication to disseminate knowledge on basic science and clinical research into the?etiology?biomechanics?treatment?methods and outcomes of all types of?spinal deformities. The international members of the Editorial Board provide a worldwide perspective for the journal's area of interest.The?journal?will enhance the mission of the Society which is to foster the optimal care of all patients with?spine?deformities worldwide. Articles published in?Spine Deformity?are Medline indexed in PubMed.? The journal publishes original articles in the form of clinical and basic research. Spine Deformity will only publish studies that have institutional review board (IRB) or similar ethics committee approval for human and animal studies and have strictly observed these guidelines. The minimum follow-up period for follow-up clinical studies is 24 months.