[Selective thoracic fusion in adolescent idiopathic scoliosis].
OBJECTIVE
To define the criteria of selective thoracic fusion in adolescent idiopathic scoliosis patients.


METHODS
By reviewing the roentgenograms of adolescent idiopathic scoliosis patients undergoing selective thoracic fusion, the curve type, Cobb angle, apical rotation and translation, trunk shift, and thoracolumbar kyphosis were measured and analyzed.


RESULTS
There were 12 King type II patients (PUMC type: IIb1 9, IIc3 3). The coronal Cobb angle of thoracic curve before and after surgery were 54.0 degrees and 19.0 degrees respectively, and the average correction rate was 62.7%. The coronal Cobb angle of lumbar curve before and after surgery were 34.6 degrees and 12.5 degrees respectively, and the average spontaneous correction rate was 64.7%. At the final follow-up, the coronal Cobb angle of thoracic and lumbar curve was 18.8 degrees and 15.9 degrees respectively. There was no significant change in the coronal Cobb angle, apical vertebral translation and rotation compared with that after surgery. 1 patient had 12 degrees of thoracolumbar kyphosis after surgery, no progression was noted at the final follow-up. There was no trunk decompensation or deterioration of the lumbar curve. In this group, 3.5 levels were saved compared with fusing both the thoracic and lumbar curves.


CONCLUSIONS
Selective thoracic fusion can be safely and effectively performed in patients with a moderate and flexible lumbar curves, which can save more mobile segments to maintain a good coronal and sagittal balance.
Zhang
Jian-guo
JG
Department of Orthopaedics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
Qiu
Gui-xing
GX
Wang
Yi-peng
YP
Weng
Xi-sheng
XS
Yu
Bin
B
Xu
Hong-guang
HG
Yang
Xin-yu
XY
Ren
Yu-zhu
YZ
D000293:Adolescent; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D013904:Thoracic Vertebrae / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome