Short fusion strategy for lenke type 1 thoracic curve using pedicle screw fixation

Morio Matsumoto, Koota Watanabe, Yoji Ogura, Eijiro Okada, Naobumi Hosogane, Kazuhiro Chiba, Yoshiaki Toyama

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

STUDY DESIGN: A retrospective case-control study OBJECTIVE: Short fusion using pedicle screws (PSs) with an attempt to attain maximum correction of the main thoracic curve was conducted for patients with a Lenke type 1 curve, to prevent postoperative left shoulder elevation. The outcomes were compared with those of conventional surgery. SUMMARY OF BACKGROUND DATA: Excessive correction of the main thoracic curve by PSs causes problematic left shoulder elevation even in a Lenke type 1 curve. METHODS: Thirty-eight patients (3 male, 35 female, mean age 16.2 years, mean follow-up 24 mo) with Lenke type 1 curve underwent posterior corrective surgery using PSs. The upper instrumented vertebra was 1 level below the end vertebra in 14 patients (short, S group), and it was at the end vertebra in 24 patients (conventional, C group). There was no difference in the preoperative Cobb angle (51.8 vs. 58.0) or curve flexibility (49.7 vs. 46.1) between the 2 groups. Radiographic results, perioperative data, and scoliosis research society 22 scores were compared between the 2 groups. RESULTS: The postoperative Cobb angle of the main curve after surgery was 13.2±5.7 degrees in the S group and 10.6±7.3 degrees in the C group (not significant). The clavicle angle was -2.1±2.8 degrees versus -2.7±2.6 degrees before surgery (not significant), and 0.8±2.3 versus 3.8±2.4 after surgery (P<0.05). The number of fused vertebrae, mean surgical time, and estimated blood loss were significantly lower in the S group than in the C group. The scoliosis research society 22 score at follow-up was not different between the 2 groups. CONCLUSIONS: The short fusion strategy for a Lenke type 1 curve can produce equivalent correction of the main curve and clinical outcomes to conventional fusion strategy with less surgical time and blood loss, while maintaining better shoulder balance.

Original languageEnglish
Pages (from-to)93-97
Number of pages5
JournalJournal of Spinal Disorders and Techniques
Volume26
Issue number2
DOIs
Publication statusPublished - 2013 Apr

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Thorax
Spine
Scoliosis
Operative Time
Surgical Blood Loss
Clavicle
Research
Case-Control Studies
Pedicle Screws

Keywords

  • idiopathic scoliosis
  • Lenke type 1
  • pedicle screw fixation
  • short fusion

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Short fusion strategy for lenke type 1 thoracic curve using pedicle screw fixation. / Matsumoto, Morio; Watanabe, Koota; Ogura, Yoji; Okada, Eijiro; Hosogane, Naobumi; Chiba, Kazuhiro; Toyama, Yoshiaki.

In: Journal of Spinal Disorders and Techniques, Vol. 26, No. 2, 04.2013, p. 93-97.

Research output: Contribution to journalArticle

Matsumoto, Morio ; Watanabe, Koota ; Ogura, Yoji ; Okada, Eijiro ; Hosogane, Naobumi ; Chiba, Kazuhiro ; Toyama, Yoshiaki. / Short fusion strategy for lenke type 1 thoracic curve using pedicle screw fixation. In: Journal of Spinal Disorders and Techniques. 2013 ; Vol. 26, No. 2. pp. 93-97.
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