Adolescent Idiopathic Scoliosis

Lenke, Lawrence G.; Betz, Randal R.; Harms, Jürgen; Bridwell, Keith H.; Clements, David H.; Lowe, Thomas G.; Blanke, Kathy

doi:10.2106/00004623-200108000-00006

Cited by 1,538 publications

(238 citation statements)

References 18 publications

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“…In these cases, the diagnosis was made on the basis of either a physical examination or a review of medical and radiographic reports, which may be less reliable. However, since our data are consistent with previously reported sex ratios in affected individuals, we believe that the probability of this limitation altering our results is low 23,24 . In addition, the lack of curve measurements for some of the family members prevented us from determining whether severity correlated with heritability.…”

Section: Discussionsupporting

confidence: 93%

Polygenic Threshold Model with Sex Dimorphism in Adolescent Idiopathic Scoliosis: The Carter Effect

Kruse

Buchan

Gurnett

et al. 2012

Journal of Bone and Joint Surgery

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Section: Discussionsupporting

confidence: 93%

Polygenic Threshold Model with Sex Dimorphism in Adolescent Idiopathic Scoliosis: The Carter Effect

Kruse

Buchan

Gurnett

et al. 2012

Journal of Bone and Joint Surgery

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“…Double major, triple major, thoracolumbar and lumbar curves were excluded from this study. According to the Lenke classification [9] there were 19 type 1A, 8 type 1B, 14 type 1C, and 2 type 2A, 4 type 2B and 1 type 2C curves. According to the King classification [10] there were 25 King II, 9 King III, 7 King IV and 7 King V curves.…”

Section: Methodsmentioning

confidence: 99%

Posterior correction of thoracic adolescent idiopathic scoliosis with pedicle screw instrumentation: results of 48 patients with minimal 10-year follow-up

2012

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Purpose Since early 1990s pedicle screws in thoracic spine have been used in posterior correction of adolescent idiopathic scoliosis (AIS). Long-term results are scarce. We report clinical, radiological and pulmonary function results of 48 consecutive patients with 10-year minimal follow-up. Methods Forty-eight consecutive patients (42 females, 6 males) with 41 Lenke 1 (lumbar modifier A = 19, B = 8, C = 14), 7 Lenke 2 (lumbar modifier A = 2, B = 4, C = 1) were operated for AIS from posterior with pedicle screw alone instrumentation. Risser stage at the time of operation was 0-3 in 24, more than 3 in 24 patients. Mean age was 15.3 years. The data were prospectively collected preoperatively, at 6 weeks, 2 years and 10 years postoperatively. Cobb angle, sagittal and coronal balance, distal adjacent disc angle and lowest fused vertebral tilt were documented at all time-points. Choice of fusion levels is described. Not every vertebra was instrumented with pedicle screws. The implant density was average one pedicle screw per vertebra or 50 %. Derotation and translation of apical vertebrae on the concave side were performed for correction. The overall outcome and the outcome of different curve types were analyzed statistically. Results Lowest instrumented vertebra (LIV) was distal end vertebra in two-thirds of the patients and was one below distal end vertebra in one-third of the patients. The main thoracic curve correction was 63 %, from 58°± 12°p reoperative to 21°± 9°at 6 weeks. The Cobb angle was 23°± 10°at 2 years and 26°± 10°at 10 years. The apical vertebral rotation improved 35 %, the non-instrumented lumbar curves improved 47 %, the distal adjacent disc angle decreased from 6°± 3°preoperatively to -2°± 4°p ostoperatively and the last instrumented vertebral tilt decreased from 23°± 8°preoperatively to 5°± 5°post-operatively. All these parameters remained stable up to 10-year follow-up. The scoliosis correction was not associated with any change in the preoperative thoracic kyphosis and lumbar lordosis. The % FVC remained unchanged with 74 ± 21 % preoperatively to 74 ± 11 % at 2 years and 75 ± 10 % at 10 years. The SRS-24 score was 93 ± 18 points at 2 years and 95 ± 22 points at 10 years. There were no neurological complications, no pedicle screw-related complications. Conclusion Posterior correction of thoracic AIS with pedicle screw instrumentation is safe and produces a longterm stable correction and high patient satisfaction. An implant density of 50 % is sufficient to achieve these results. LIV can be the distal end vertebra or one below the distal end vertebra depending on the position of the distal end vertebra to the centre sacral line. The preoperative pulmonary function does not change on long term.Keywords Adolescent idiopathic scoliosis Á Selective posterior correction with pedicle screw instrumentation Á Choice of fusion levels Á Long-term operative results Á Long-term pulmonary function

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“…The Cobb method (10) was used for all curve measurements. Lenke classification was used to classify different curves (9). The frequency of each parameter of Lenke classification alone, and their intrarelationship was assessed.…”

Section: Methodsmentioning

confidence: 99%

“…Due to more understanding of 3-dimensional character of spinal deformity in adolescent idiopathic scoliosis (AIS), (2)(3)(4), and new segmental instrumentation emerged recently (5)(6)(7)(8), attention is paid to sagittal balance and rotation of the spine. This led to a new classification system, which incorporated these parameters in itself and was introduced by Lenke et al ( 9). The Lenke classification considered 3 parameters:…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Thoracic Hyperkyphosis in Patients with Adolescent Idiopathic Scoliosis

et al. 2017

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Background: There are different classifications for adolescent idiopathic scoliosis (AIS), among which Lenke classification is the most recent and comprehensive method. It is 3 dimensional and treatment organized. In most previous studies, thoracic hypokyphosis was more common, but it may be different in many patients. Objectives: The current study aimed at assessing the prevalence of thoracic hyperkyphosis in AIS for the first time in Iranian population. Methods:The study was performed retrospectively on 242 patients with AIS treated surgically in the university hospital from 2009 to 2014. Three parameters were evaluated in each patient including the 6 curve types of Lenke classification, thoracic sagittal balance, and lumbar spine modifier. Results: Adolescent idiopathic scoliosis was more common in female patients (83.5%). Type one curve was the most common type (48%). In lumbar spine modifier, type A was the most common (44%), similar to other studies. Hyperkyphosis was the most common type of thoracic sagittal balance (54%), which was in contrast to the original study by Lenke. The mean thoracic sagittal balance was hyperkyphosis in all Lenke types except type 5, which was normal. No relationship was found between the prevalence of thoracic kyphosis, and lumbar spine modifier, or the 6 types of Lenke classification. Conclusions:The frequency of different types of curves in Iranian population was the same as that of the original article by Lenke except that in the current study more thoracic hyperkyphosis was observed than hypokyphosis in the population.

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Adolescent Idiopathic Scoliosis

Cited by 1,538 publications

References 18 publications

Polygenic Threshold Model with Sex Dimorphism in Adolescent Idiopathic Scoliosis: The Carter Effect

Polygenic Threshold Model with Sex Dimorphism in Adolescent Idiopathic Scoliosis: The Carter Effect

Posterior correction of thoracic adolescent idiopathic scoliosis with pedicle screw instrumentation: results of 48 patients with minimal 10-year follow-up

Prevalence of Thoracic Hyperkyphosis in Patients with Adolescent Idiopathic Scoliosis

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