title: Selective anterior thoracolumbar/lumbar fusion and instrumentation in adolescent idiopathic scoliosis patients.
abstract: BACKGROUND
  Selective anterior thoracolumbar/lumbar (TL/L) fusion and instrumentation in adolescent idiopathic scoliosis (AIS) patients with a structural major TL/L curve and a nonstructural minor thoracic curve is rarely reported. We investigate the correction results of these patients.
  
  
  METHODS
  By reviewing the medical records and roentgenograms of AIS patients undergone selective anterior TL/L fusion and instrumentation, Cobb angle, correction rate of the major and minor curves, coronal balance, lowest instrumented vertebra (LIV) tilt, coronal disc angle immediately below the LIV (LIVDA) and radiographic shoulder height (RSH) were measured and analyzed.
  
  
  RESULTS
  Forty patients were included. For the major TL/L curve, the mean coronal Cobb angle before and after operation were 43.9° and 8.7°, respectively, with an average correction rate of 80.2% (P = 0.000). While for the minor thoracic curve, the mean coronal Cobb angle before and after operation were 27.2° and 14.3°, respectively, with an average spontaneous correction rate of 47.4% (P = 0.000). At final follow-up, the coronal Cobb angles of the major and minor curves were 13.7° and 17.1°, respectively, with a mean correction loss of 5.0° and 2.9°, respectively. The coronal balance before and after operations was 13.2 mm and 11.5 mm, respectively. At the final follow-up, it turned to 5.6 mm, which was much better than that after operation (P = 0.001). The mean LIV tilt was 23.5° before operation, and was significantly improved after operation (8.3°, P = 0.000). At final follow-up, it was well maintained (10.6°). The LIVDA averaged 3.5° before operation, and aggravated to 5.5° after operation (P = 0.100) and 7.4° at final follow-up (P = 0.012), respectively. The RSH was 7.3 mm before operation, 5.6 mm after operation, and 2.2 mm at the final follow-up. The RSH at the final follow-up was significantly improved compared with that after operation (P = 0.002).
  
  
  CONCLUSIONS
  Selective anterior TL/L fusion and instrumentation can get good correction results of both curves, with good results of the coronal balance and RSH in AIS patients, while a larger LIVDA.
authors.affiliation: Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Yu
authors.forename: Jian-Guo
authors.initials: JG
authors.lastname: Zhang
authors.forename: Gui-Xing
authors.initials: GX
authors.lastname: Qiu
authors.forename: Wen-Can
authors.initials: WC
authors.lastname: Lu
authors.forename: Yi-Peng
authors.initials: YP
authors.lastname: Wang
authors.forename: Jian-Xiong
authors.initials: JX
authors.lastname: Shen
authors.forename: Qi
authors.initials: Q
authors.lastname: Fei
authors.forename: Qi-Yi
authors.initials: QY
authors.lastname: Li
authors.forename: Xi-Sheng
authors.initials: XS
authors.lastname: Weng
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D013904:Thoracic Vertebrae / Q000601:surgery*; D016896:Treatment Outcome