Radiographic predictors of outcome after long fusion to L5 in adult scoliosis.
Radiographic factors that correlate with outcome following long posterior fusion to L5 for adult scoliosis were investigated. Measurement of thoracic, lumbar, and fractional lumbosacral curves, L5 obliquity, lumbar and L5-S1 lordosis, coronal balance, sagittal balance, and L5-S1 disc height were performed on preoperative, postoperative, and follow-up 36-in posteroanterior/lateral radiographs. Of 16 patients, 14 were female (88%) and 2 male (12%). Average follow-up was 32 months (8-78 months). Scoliotic curves demonstrated stable corrections; however, lumbar and L5-S1 lordosis decreased and sagittal decompensation worsened. Ten patients (62%) had no evidence of transitional degeneration. Six patients (38%) had radiographic evidence of L5-S1 degeneration, and three (19%) underwent revision. Patients with good preoperative sagittal balance, preserved lumbar lordosis, good postoperative fractional curve correction, and L5-S1 disc height preservation are most likely to benefit from posterior fusion to L5, avoiding sacral fusion, for adult scoliosis.
Brown
Karen M
KM
Department of Orthopaedics and Rehabilitation, The Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA. khuang@psu.edu
Ludwig
Steven C
SC
Gelb
Daniel E
DE
D000328:Adult; D000368:Aged; D015984:Causality; D005260:Female; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects / Q000592:standards*; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control; D008141:Lordosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control; D008159:Lumbar Vertebrae / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control; D011237:Predictive Value of Tests; D011859:Radiography; D012189:Retrospective Studies; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D013131:Spine / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome