Journal
BMC MUSCULOSKELETAL DISORDERS
Volume 23, Issue 1, Pages -Publisher
BMC
DOI: 10.1186/s12891-022-05559-4
Keywords
Adolescent idiopathic scoliosis; Lenke 5C; Surgery; Adding-on; Lower instrumented vertebra; Last barely touched vertebra; Last substantial touched vertebra
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Funding
- National Natural Science Foundation of China [81904020, 82072505, 82130072]
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This study evaluated the incidence and risk factors of postoperative distal adding-on in patients with Lenke 5C AIS. The postoperative TL/L curve, LIV translation, LIV + 1 translation, and postoperative coronal imbalance were determined as risk factors for postoperative distal adding-on. Moreover, selecting LBTV-1 or LSTV-1 as the LIV may increase the risk of postoperative distal adding-on.
Background To evaluate the incidence and risk factors of postoperative distal adding-on in patients with Lenke 5C adolescent idiopathic scoliosis (AIS). More accurate selection criteria for the lower instrumented vertebra (LIV) should be confirmed to prevent distal adding-on. Methods Forty-six patients with Lenke 5C AIS who underwent posterior fusion were enrolled in the study. Patients were allocated into adding-on and no adding-on groups. Demographic data, clinical data, and radiographic parameters were recorded and compared. Results Postoperative distal adding-on occurred in eight patients (17.4%) during follow-up. Demographic data, clinical data, and baseline radiographic parameters of the two groups were not significantly different. The postoperative thoracolumbar (TL) or lumbar (L) Cobb angle, LIV translation, and LIV + 1 translation were higher in the adding-on group than those in the no adding-on group, while the postoperative coronal imbalance of the adding-on group was lower than that of the no adding-on group. The level difference of last barely touched vertebra (LBTV) and last substantial touched vertebra (LSTV) with LIV were higher in the adding-on group than in the no adding-on group. Conclusion Postoperative TL/L curve, postoperative LIV translation, postoperative LIV + 1 translation, and postoperative coronal imbalance were determined as risk factors for postoperative distal adding-on in patients with Lenke 5C AIS. Moreover, LIV selection of LBTV-1 or LSTV-1 may cause a higher risk of postoperative distal adding-on.
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