title: Influence of scoliosis corrrection in the thoracic spine on posture compensation in patients with King's type II scoliosis (Lenke's IB, IC).
abstract: Background. The aim of our study was to assess the course and outcome in scoliosis without spondylodesis in the lumbar spine after surgical correction performed in the thoracic segment with the C-D method in patients with King's type II scoliosis (Lenke's IB, IC). Material and methods. 42 patients with idiopathic scoliosis were operated in the thoracic spine. The Cobb's angle averaged 635 +/- 9.2 degrees , together with coexistent lumbar scoliosis of 50.1 +/- 13.2 degrees . The mean observation time after surgery with the C-D method was 4.3 +/- 1.8 years. Both curvatures of correction, thoracic kyphosis, and lumbar lordosis were evaluated, as well as the thoracic-lumbar angle and shape of the lumbar scoliosis in relation to the central vertical sacral line were analyzed. Results. C-D surgery corrected thoracic scoliosis up to 28.8 +/- 8.3 degrees (54.6% scoliosis correction). Secondary correction of lumbar scoliosis not treated with C-D instrumentation made it possible to obtain a Cobb's angle of 28.9 +/- 9.7 degrees (42.3% scoliosis). Selective instrumentation and spondylodesis of scoliosis in the thoracic spine coexisted with transient decompensation of the posture on the left after surgery in 7 patients. Subsequent postsurgical observation showed the percentage of scoliosis correction in the lumbar spine decreasing to 32.7% and then to 29%. The number of patients with posture decompensation decreased to 2 cases. Conclusions. Equilibrated correction of scoliosis at the thoracic level reaching 50-60% of initial value is correlated in postsurgical observation with a small percentage of secondary decompensation of posture. The number of patients with postoperative decompensation decreases with corrections in the lumbar spine not treated with instrumentation during scoliosis surgery.
authors.affiliation: Katedra i Klinika Ortopedii i Traumatologii Dzieciecej Akademii Medycznej.
authors.forename: Maciej
authors.initials: M
authors.lastname: Głowacki
authors.forename: Andrzej
authors.initials: A
authors.lastname: Szulc
authors.forename: Juliusz
authors.initials: J
authors.lastname: Huber
authors.forename: Wojciech
authors.initials: W
authors.lastname: Strzyzewski