• Kei Ando, Shiro Imagama, Zenya Ito, Kazuyoshi Kobayashi, Tetsuro Hida, Kenyu Ito, Akito Tsushima, Yoshimoto Ishikawa, Akiyuki Matsumoto, Yoshihiro Nishida, and Naoki Ishiguro.
• Eur J Orthop Surg Tr. 2016 Jan 1; 26 (1): 59-66.

ObjectiveTo investigate what type of Lenke 5C patient benefits most from a fusion to L3 as the LIV.MethodsThe subjects were 16 patients who underwent fusion surgery to L3 as the lowest instrumented vertebra (LIV), and who were then observed for a minimum of 2 years postoperatively. We considered an unsatisfactory radiologic outcome for the distal adjacent curve (DAD) to be an L3 or L4 tilt angle less than 10° or L3/4 disc wedging less than 10°. Patients were divided into 2 groups based on the radiologic outcome of the distal curve: the distal adjacent disorder+ (DAD+) and the distal adjacent disorder-(DAD-). We compared global balance, Cobb angles (thoracic and lumbar), L3 and L4 tilt angles and L3/4/5 disc angles between the 2 groups on preoperative, postoperative and final radiographs.ResultsSeven patients (43.8 %) met the criteria for the DAD+ group. On preoperative radiographs, there was a significant difference in the L3/4 disc angle: the DAD+ group opened to the preoperative convex side (-2.1° ± 3.0°) and the DAD- group opened to the preoperative concave side (4.7° ± 5.1°). The standing L3- and L4-CSVL and the L4-CSVL under traction were significantly different.ConclusionsIn Lenke 5C patients who underwent fusion surgery to L3 as the LIV, preoperative LIV (L3), LIV + 1 (L4) translation and L3/4 disc angle on standing, plus LIV + 1 translation under traction were very important parameters correlating with postoperative global coronal balance.

24 keywords...

hide…