Curve Prevalence of a New Classification of Operative Adolescent Idiopathic Scoliosis

Lenke, Lawrence G.; Betz, Randal R.; Clements, David H.; Merola, Andrew A.; Häher, Thomas R.; Lowe, Thomas G.; Newton, Peter O.; Bridwell, Keith H.; Blanke, Kathy

doi:10.1097/00007632-200203150-00008

Cited by 183 publications

(108 citation statements)

References 22 publications

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“…Yet many surgeons prefer to fuse both curves. One study showed that selective thoracic fusion was performed in 62% of patients with Lenke 1C curves [14]. This study found that both the thoracic and lumbar curves are fused in 38% of the Lenke 1C curves.…”

Section: Introductionmentioning

confidence: 86%

“…The King Type II curve is known as the ''false double major'' pattern, because the lumbar curve shows less magnitude and more flexibility on side-bending films which suggests that it is a compensatory curve present only to maintain coronal balance in the setting of a fixed thoracic curve. The King Type II curve was later reclassified by Lenke et al [13][14][15] as Lenke 1C, 2C, 3C, and 4C curves. Controversy exists over the treatment of the compensatory lumbar curve in King Type II curves [15,16].…”

Section: Introductionmentioning

confidence: 99%

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Selective fusion for adolescent idiopathic scoliosis: a review of current operative strategy

Fischer

Kim

2011

Eur Spine J

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Selective fusion of thoracic and thoracolumbar/ lumbar curves in adolescent idiopathic scoliosis is a concept critically debated in the literature. While some surgeons strongly believe that a more rigid and straighter spine provides predictably excellent outcomes, some surgeons recommend a mobile and less straight spine. This topic is a crucial part of surgical treatment of idiopathic scoliosis, particularly in young patients who will deal with the stress of the fusion mass at the proximal and distal junctions over many years. This study will review the literature on various aspects of selective fusion.

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Section: Introductionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Selective fusion for adolescent idiopathic scoliosis: a review of current operative strategy

Fischer

Kim

2011

Eur Spine J

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“…Elias Lenke et al 15 , em estudo multicêntrico retrospectivo classificaram, de acordo com King 24 , 606 pacientes, e encontram 51% de curvas do tipo I, 20% do tipo II, 11% do tipo III, 3% do tipo IV, 12% do tipo V e 17,3% do tipo VI, já no nosso estudo encontramos a maioria das curvas torácicas tipo II de King seguido do tipo III.…”

Section: Discussionunclassified

“…Do ponto de vista acadêmico, o nosso trabalho tem o objetivo de levantar dados epidemiológicos sobre escoliose vertebral em nossos estado, assim como classificar as escolioses idiopáticas do adolescente (EIA) segundo Nery et al 13 , Lenke et al 14,15 , e Winter et al 16 . para escoliose congênita e neuromuscular ,respectivamente, para no futuro definir a melhor forma de tratamento.…”

Section: Introductionunclassified

Estudo descritivo sobre o primeiro mutirão no Brasil de cirurgias eletivas para tratamento de escoliose

et al. 2012

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RESUMOObjetivo: Descrever os resultados estatísticos do primeiro mutirão de cirurgias eletivas realizado no Brasil, não somente com o intuito de divulgar a iniciativa, mas, sobretudo, para que o conhecimento dessas ações possa incentivar outros estados e também outros mutirões no Espírito Santo. Método: Estudo descritivo observacional transversal, em que foram avaliados pessoas oriundas da Grande Vitória e do interior do estado do Espírito Santo com deformidades ou sintomas álgicos na região dorsal de origem osteomuscular, classificando-as de acordo com a idade, sexo e patologia, e quando diagnosticado escoliose, se possível classifica-la segundo King, Lenke, Winter et al. e Lounstein e Akbarnia, indicando-se tratamento. Resultados: Foram avaliados 169 pacientes, sendo 48 homens e 121 mulheres, com média de idade de 39,7 anos e 41,1 anos, respectivamente. Foi encontrado 25,4% de pacientes com doenças ortopédicas em geral, 36,1% de doenças específicas da coluna vertebral exceto escoliose e 38,5% de escoliose. Dos pacientes com escoliose, 81,5% eram idiopática do adolescente, com maioria classificada por King como tipo II e por Lenke como tipo I. Dentre outras etiologias da escoliose, a congênita mais comum foi a hemivertebra associada a barra contralateral quando classificado por Winter et al. e das neuromusculares o tipo 2B da classificação de Louenstein e Akbarnia. Conclusão: Nossos dados epidemiológicos corroboram com a literatura atual. Conseguimos alcançar um numero satisfatório de pacientes com doenças da coluna vertebral, determinar um tratamento e acompanhamento e, ainda, divulgar e orientar a população sobre tais doenças.Descritores: Escoliose/epidemiologia; Escólios/patologia; Escoliose/cirurgia; Doenças da coluna vertebral. King, Lenke, Winter et al. and Lounstein and Akbarnia, and ABSTRACT Objective: Describe the statistical results of the first campaign for elective surgeries performed in Brazil, not only in order to make the initiative public, but more importantly, so that the knowledge of these actions will encourage other States and also other collaborative efforts in Espírito Santo. Methods: Descriptive cross-sectional observational study, which evaluated people from Grande Vitória and from the State of Espirito Santo with deformities or dorsal pain of musculoskeletal origin, classifying them according to age, sex and pathology, and when the diagnosis was scoliosis, if possible classified according to

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“…The Lenke classification system for AIS was utilized, which has been shown to be accurate and reproducible and correlates with treatment of surgically structural regions of the spine [12,13,21]. Multiple radiographic measurements were assessed on the preoperative, immediate postoperative standing, and final postoperative long cassette biplanar radiographs.…”

Section: Methodsmentioning

confidence: 99%

Financial analysis of circumferential fusion versus posterior-only with thoracic pedicle screw constructs for main thoracic idiopathic curves between 70° and 100°

Luhmann

Lenke

Kim

et al. 2008

Journal of Children's Orthopaedics

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Purpose Reports on thoracic pedicle screw (TPS) constructs have demonstrated their safety and efficacy; however, concerns exist regarding their increased cost. This is a review of adolescents with main thoracic scoliosis surgically treated with anterior release and posterior fusion or posterior fusion only. The objectives were to compare the radiographic outcomes and financial data of two surgical treatments: anterior/posterior spinal fusion (APSF) versus posterior spinal fusion (PSF-TPS) alone with TPSs, in patients with large 70-100°main thoracic adolescent idiopathic scoliosis (AIS) curves.Methods We identified 43 patients with main thoracic Lenke type 1-4 AIS curves between 70 and 100°who had been treated with either APSF or PSF-TPS. Results Both groups had equivalent radiographic corrections postoperatively. The PSF-TPS group patients had higher implant charges, but the APSF group had higher surgeon procedural charges, operating room charges, anesthesia charges, and inpatient room charges. Total charges were $75,295 for the APSF group and $71,236 for the PSF-TPS group (P [ 0.05). Analyses of two subgroups of the APSF group, anterior release via thoracotomy versus VATS and same-day versus staged surgeries, failed to change any of the above findings. Conclusion Based on this financial analysis, there was no statistically significant differences between the APSF and PSF-TPS groups, with equivalent radiographic corrections.Keywords Adolescent idiopathic scoliosis Á Scoliosis surgery Á Anterior spinal fusion Á Posterior spinal fusion Á Pedicle screws Key points• Posterior-only spinal fusion utilizing thoracic pedicle screws has an equivalent degree of curve correction to combined anterior and posterior spinal fusions.• Higher surgical implant charges in the posterior-only spinal fusion utilizing thoracic pedicle screws were due not only to the higher implant charge per unit but also to a greater number of overall implant fixation points.• Posterior spinal fusions with thoracic pedicle screws were not more expensive than circumferential fusion for curves between 70 and 100°.

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Curve Prevalence of a New Classification of Operative Adolescent Idiopathic Scoliosis

Cited by 183 publications

References 22 publications

Selective fusion for adolescent idiopathic scoliosis: a review of current operative strategy

Selective fusion for adolescent idiopathic scoliosis: a review of current operative strategy

Estudo descritivo sobre o primeiro mutirão no Brasil de cirurgias eletivas para tratamento de escoliose

Financial analysis of circumferential fusion versus posterior-only with thoracic pedicle screw constructs for main thoracic idiopathic curves between 70° and 100°

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