Sagittal plane lumbar responses after anterior selective thoracic fusion for main thoracic adolescent idiopathic scoliosis.
METHODS
A retrospective radiographic study.


OBJECTIVE
To verify the correlation of sagittal and coronal plane changes after selective thoracic fusion in main thoracic (MT) adolescent idiopathic scoliosis (AIS).


BACKGROUND
Sagittal plane deformity is known to be essential in the evolution of scoliosis.


METHODS
Twenty-eight MT AIS patients treated by anterior selective thoracic fusion were evaluated after minimal follow-up of two years. The unfused lumbar area was divided into proximal and distal parts by the lumbar apex in the coronal plane, and into proximal and distal lumbar lordosis by L2 in the sagittal plane. Surgical motion (the difference between preoperative and postoperative values) and follow-up motion (the difference between postoperative and the last follow-up values) were compared.


RESULTS
Immediately after surgery, as thoracic kyphosis increased, lumbar lordosis decreased (r=0.734); proximal lumbar lordosis increased, and distal lumbar lordosis decreased. The proximal lumbar area was mobilized in the sagittal plane, and was straightened in the coronal plane. However, the distal lumbar area was stabilized in the sagittal plane, and showed resistant motion against MT translation in the coronal plane. The surgical motion was correlated to the follow-up motion, i. e., was regulated during follow-up, and the regulatory motion was more precise in the distal than proximal lumbar area in both sagittal and coronal planes.


CONCLUSIONS
Sagittal and coronal motions were co-related; optimal sagittal motions were necessary for optimal coronal motions after anterior selective thoracic fusion for MT AIS. Proximal and distal lumbar motions were different for different roles; the proximal lumbar area played a role as a bumper to absorb the MT translatory force, and the distal lumbar area played a role of resistance against MT translation.
Na
Ki-Ho
KH
Department of Orthopedic Surgery, St. Paul's Hospital, Kang-Nam St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
Harms
Jürgen
J
Ha
Kee-Yong
KY
Choi
Nam-Yong
NY
J Bone Joint Surg Br. 1984 Jan;66(1):8-15
6693483
Spine (Phila Pa 1976). 1995 Dec 1;20(23):2487-92
8610242
Spine (Phila Pa 1976). 1992 Aug;17(8 Suppl):S263-9
1523510
Eur Spine J. 2000 Apr;9(2):156-60
10823433
Spine (Phila Pa 1976). 1991 Jul;16(7):769-77
1925753
J Bone Joint Surg Am. 1972 Apr;54(3):511-33
5055150
Med Hypotheses. 2005;65(3):501-8
15913901
Spine (Phila Pa 1976). 2006 Jun 1;31(13):1467-72
16741456
Spine (Phila Pa 1976). 1990 Apr;15(4):271-4
2353272
Spine (Phila Pa 1976). 1991 Aug;16(8 Suppl):S394-403
1785094
Spine (Phila Pa 1976). 1991 Aug;16(8 Suppl):S404-8
1785095
Spine (Phila Pa 1976). 1991 Aug;16(8 Suppl):S391-3
1785093
Eur Spine J. 2006 Jul;15(7):1128-38
16470398
Spine (Phila Pa 1976). 1990 Sep;15(9):927-31
2259983
J Spinal Disord. 1991 Jun;4(2):188-92
1806083