Skip to main content
main-content

12.04.2019 | Original Article | Ausgabe 6/2019

European Spine Journal 6/2019

L3 translation predicts when L3 is not distal enough for an “ideal” result in Lenke 5 curves

Zeitschrift:
European Spine Journal > Ausgabe 6/2019
Autoren:
Lee Phillips, Burt Yaszay, Tracey P. Bastrom, Suken A. Shah, Baron S. Lonner, Firoz Miyanji, Amer F. Samdani, Stefan Parent, Jahangir Asghar, Patrick J. Cahill, Peter O. Newton
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00586-019-05960-z) contains supplementary material, which is available to authorized users.

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Abstract

Purpose

Determining whether to fuse a Lenke 5 curve to L3 or to L4 is often a difficult decision. The purpose of this study was to determine preoperative variables predictive of an “ideal” or “less than ideal” outcome for Lenke 5 curves instrumented to L3.

Methods

A multicentre registry of adolescent idiopathic scoliosis patients was queried for surgically treated Lenke 5 curves with a lowest instrumented vertebra (LIV) of L3 and minimum 2 years of follow-up. Five seasoned surgeons qualitatively rated the 2-year postoperative images as “ideal” or “less than ideal” with respect to correction and alignment. Preoperative and postoperative radiographic variables were compared between the two groups. Multivariate regression analysis was performed to determine variables most predictive of a “less than ideal” outcome.

Results

One hundred and thirty-nine patients met criteria. Twenty-three were considered “less than ideal” by ≥ 3 surgeons; 81 were unanimously “ideal”. Preoperatively, the “less than ideal” group had significantly stiffer curves, greater apical translation, and greater LIV angulation and translation. Multivariate regression found that preoperative L3 translation (p = 0.009) was the single most important predictor of a “less than ideal” outcome: < 3.5 cm consistently resulted in an “ideal” outcome, while > 3.5 cm risked a “less than ideal” result.

Conclusion

While multiple variables are important in achieving an “ideal” outcome in Lenke 5 curves, this study found preoperative L3 translation was the most important predictor of success with an L3 translation < 3.5 cm being a potential threshold for selecting L3 as the LIV.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

★ PREMIUM-INHALT
e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de. Zusätzlich können Sie eine Zeitschrift Ihrer Wahl in gedruckter Form beziehen – ohne Aufpreis.

Weitere Produktempfehlungen anzeigen
Zusatzmaterial
Supplementary material 1 (PPTX 8898 kb)
586_2019_5960_MOESM1_ESM.pptx
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 6/2019

European Spine Journal 6/2019 Zur Ausgabe

Announcements

Announcements

  1. Sie können e.Med Orthopädie & Unfallchirurgie 14 Tage kostenlos testen (keine Print-Zeitschrift enthalten). Der Test läuft automatisch und formlos aus. Es kann nur einmal getestet werden.

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Orthopädie und Unfallchirurgie und bleiben Sie gut informiert – ganz bequem per eMail.

Bildnachweise