title: Short fusion strategy for thoracolumbar and lumbar adolescent idiopathic scoliosis using anterior dual-rod instrumentation.
abstract: OBJECTIVE
  A total of 30 patients with thoracolumbar/lumbar adolescent idiopathic scoliosis (AIS) treated between 1989 and 2000 with anterior correction and fusion surgery using dual-rod instrumentation were reviewed.
  
  
  METHODS
  Radiographic parameters and clinical outcomes were compared among patients with lowest instrumented vertebra (LIV) at the lower end vertebra (LEV; EV group) (n = 13) and those treated by short fusion (S group), with LIV one level proximal to EV (n = 17 patients).
  
  
  RESULTS
  The allocation of the surgical technique was determined by the flexibility of the TL/L curves and/or neutral vertebrae located one level above LEV as determined on preoperative radiographs. If these requirements were met a short fusion was performed. The mean follow-up period was 21.4 years (16 to 27). The mean correction rate at final follow-up was significantly lower in the S group (74 sd 11%) than in the EV group (88 sd 13%) (p = 0.004).Coronal and sagittal balance, thoracic kyphosis, lumbar lordosis, and clinical outcomes evaluated by the Scoliosis Research Society-22 questionnaire scores were equivalent between the two groups.
  
  
  CONCLUSIONS
  Short fusion strategy, which uses LIV one level proximal to LEV can be considered as an alternative to the conventional strategy, which includes LEV in the fusion, when highly flexible TL/L curves are confirmed and/or neutral vertebrae are located one level above LEV in patients with thoracolumbar/lumbar AIS curves.
  
  
  CONCLUSIONS
  Short fusion strategy can be considered as an alternative to the conventional strategy in patients with thoracolumbar/lumbar AIS curves undergoing anterior spinal fusion with dual-rod instrumentation. Cite this article: Bone Joint J 2016;98-B:402-9.
authors.affiliation: Hokkaido University Graduate School of Medicine, North-15, West-7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Sudo
authors.affiliation: Orthopaedic Hokushin Hospital, Kikusuimotomachi 3-3, Sapporo, Hokkaido 003-0823, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Kaneda
authors.affiliation: Japan Community Health Care Organization Hokkaido Hospital, Nakanoshima 1-8, Sapporo, Hokkaido 062-8618, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Shono
authors.affiliation: Hokkaido University Graduate School of Medicine, North-15, West-7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Iwasaki
mesh_terms: D000293:Adolescent; D001858:Bone Nails; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: adolescent idiopathic scoliosis;anterior spinal fusion;short fusion;long-term follow-up