title: The Surgical Overcorrection of Lenke Type 1 Deformities with Selective Fusion Segments: What Happens to the Coronal Balance?
abstract: OBJECTIVE
  The aim of our study is to determine the alterations on coronal balance after overcorrection of Lenke type 1 curve, retrospectively.
  
  
  METHODS
  Datas of 34 patients (29 female, 5 male patients; mean age, 16.3±3.3 years; range, 13-24 years) surgically treated for scoliosis between 2004 and 2010 were reviewed, retrospectively. The adolescent idiopathic scoliosis patients with Lenke type 1 curve treated with only posterior pedicle screw and postoperative thoracic curves less than 10° by Cobb method on frontal plane were enrolled in this study. Mean follow-up period was 52.5±29.7 months.
  
  
  RESULTS
  The mean amount of the preoperative thoracic curves was measured as 41.2°±6.1° (range, 30°-56°). The mean amount of the early postoperative thoracic curves was measured as 6.5°±1.8° (range, 3°-9°). The mean amount of the thoracic curves was measured as 8.5°±4.6° (range, 3°-22°) during the last follow-up (p=0.01). The mean preoperative coronal balance was measured as 8.5mm(range, 1-30mm). The mean early postoperative coronal balance was measured as 3.5mm(range, 0-36 mm). The mean coronal balance was measured as 5.5mm(range, 0-38mm) during the last follow-up (p>0.05).
  
  
  CONCLUSIONS
  We suggest that Lenke type 1B and 1C should be carefully evaluated and the fusion levels should be accurately selected in order to maintain the correction of coronal balance. We suggest that selective fusion with overcorrection in Lenke type 1A are applied to curves that can be corrected lumbar curve at the preoperative bending radiograph and curves that not have coronal decompensation and >10° distal junctional kyphosis, preoperatively.
authors: Department of Orthopaedics and Traumatolgy, Carsamba State Hospital, Samsun, Turkey.
authors: Yunus
authors: Y
authors: Atici
authors: Department of Orthopaedics and Traumatolgy, LIV Hospital, Istanbul, Turkey.
authors: Sinan
authors: S
authors: Erdogan
authors: Department of Orthopaedics and Traumatology, Metin Sabanci Baltalimani Bone Diseases Training and Research Hospital, Istanbul, Turkey.
authors: Yunus Emre
authors: YE
authors: Akman
authors: Department of Orthopaedics and Traumatology, Gaziosmanpasa University, Istanbul, Turkey.
authors: Murat
authors: M
authors: Mert
authors: Department of Orthopaedics and Traumatology, Medipol University, Istanbul, Turkey.
authors: Engin
authors: E
authors: Carkci
authors: Department of Orthopaedics and Traumatology, Istanbul Training and Research Hospital, Istanbul, Turkey.
authors: Tolga
authors: T
authors: Tuzuner
keywords: Coronal balance; Overcorrection; Scoliosis; Selective fusion