• Xiexiang Shao, Tianyuan Zhang, Jingfan Yang, Yaolong Deng, Zifang Huang, Junlin Yang, and Wenyuan Sui.
• Spine Center, Xinhua Hospital Affiliated to Shanghai Jiao Tong University Shanghai Jiao Tong University, Shanghai, 200092, China.
• Eur Spine J. 2023 Apr 1; 32 (4): 115311601153-1160.

PurposeTo investigate lowest instrumented vertebra (LIV) selection strategy for neurofibromatosis type 1 (NF-1) non-dystrophic scoliosis.MethodsConsecutive eligible subjects with NF-1 non-dystrophic scoliosis were included. All patients were followed up at least for 24 months. Enrolled patients with LIV in stable vertebra were divided into stable vertebra group (SV group), and the other patients with LIV above the stable vertebra were divided into above stable vertebra group (ASV group). Demographic data, operative data, preoperative and postoperative radiographic data, and clinical outcome were collected and analyzed.ResultsThere were 14 patients in SV group (ten males and four females, mean age 13.9 ± 4.1 years) and 14 patients in ASV group (nine males and five females, mean age 12.9 ± 3.5 years). The mean follow-up period was 31.7 ± 17.4 months for patients in SV group and 33.6 ± 17.4 months for patients in ASV group, respectively. No significant differences were found in demographic data between two groups. The coronal Cobb angle, C7-CSVL, AVT, LIVDA, LIV tilt and SRS-22 questionnaire outcome significantly improved at the final follow-up in both groups. However, significantly higher loss of correction rate and increasement of LIVDA were found in ASV group. Two patients (14.3%) in ASV group but none in SV group suffered adding-on phenomenon.ConclusionsAlthough patients in both SV and ASV groups obtained improved therapeutic efficacy at final follow-up, the radiographic and clinical outcome seemed more likely to deteriorate in ASV group after surgery. The stable vertebra should be recommended as LIV for NF-1 non-dystrophic scoliosis.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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