Surgical increase in thoracic kyphosis increases unfused lumbar lordosis in selective fusion for thoracic adolescent idiopathic scoliosis

Surgical increase in thoracic kyphosis increases unfused lumbar lordosis in selective fusion for thoracic adolescent idiopathic scoliosis

Jean-Luc Clément, Yann Pelletier, Federico Solla, Virginie Rampal

September 2018, pp 1 - 9
DOI
10.1007/s00586-018-5740-8
First Online: 11 September 2018
Abstract

Purpose

In adolescent idiopathic scoliosis (AIS), there is a close relationship between thoracic kyphosis (TK) and proximal lumbar lordosis (PLL). The hypothesis states correction of hypokyphosis increases lumbar lordosis (LL) through increase in PLL after surgical correction of TK.

Methods

111 consecutive thoracic AIS, Lenke 1 or 2 who underwent posterior selective thoracic fusion with reduction by simultaneous translation on 2 rods and 2 years follow-up have been prospectively selected and analyzed. Instrumentations below L1 and anterior releases were excluded. Global TK and LL were measured by a dedicated software. Mean values were compared through T test, correlations assessed through Pearson’s coefficient.

Results

Global TK increased from 27° to 46° at the last follow-up (p 

Conclusions

Increase in TK led to increase in uninstrumented LL through increase in PLL with a continuous correlation between TK and PLL. These results allow surgeons to calculate the TK required during surgical correction of thoracic AIS to adapt LL to pelvic incidence.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.]