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Choosing the Distal Fusion Levels in Lenke Type 1 Adolescent Idiopathic Scoliosis: How Do the Existing Classifications and Recommendations Guide Us?

STUDY DESIGN: Retrospective cohort. OBJECTIVE: (a) To compare the recommendations of Lenke and Peking Union Medical College (PUMC) classifications in choosing distal fusion levels in Lenke 1 adolescent idiopathic scoliosis (AIS) curves and (b) to analyze whether the variability in distal fusion leve...

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Autores principales: Garg, Bhavuk, Mehta, Nishank, Mukherjee, Rudra Narayan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8119905/
https://www.ncbi.nlm.nih.gov/pubmed/32875882
http://dx.doi.org/10.1177/2192568220910712
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author Garg, Bhavuk
Mehta, Nishank
Mukherjee, Rudra Narayan
author_facet Garg, Bhavuk
Mehta, Nishank
Mukherjee, Rudra Narayan
author_sort Garg, Bhavuk
collection PubMed
description STUDY DESIGN: Retrospective cohort. OBJECTIVE: (a) To compare the recommendations of Lenke and Peking Union Medical College (PUMC) classifications in choosing distal fusion levels in Lenke 1 adolescent idiopathic scoliosis (AIS) curves and (b) to analyze whether the variability in distal fusion levels influences treatment outcomes. METHODS: Hospital records of Lenke 1 AIS patients operated for single stage, posterior-only deformity correction were analyzed. Distal fusion levels recommended by Lenke and PUMC classifications were calculated and were compared with the actual distal fusion levels. The study population was divided based on whether the actual distal fusion levels were in agreement, shorter or longer than those recommended by Lenke classification. Subgroup analysis of Lenke 1C curves was done. The groups were compared with regard to the following outcome measures: Cobb angle correction, postoperative sagittal vertical axis, postoperative C7 offset, and Scoliosis Research Society–22r (SRS-22r) score at 24 months. RESULTS: The distal fusion levels recommended by the 2 classifications were in agreement in 92 of 104 cases. In all the cases with disparity, Lenke classification recommended shorter fusions than the PUMC classification. No statistically significant difference was observed in the outcome measures—whether the actual distal fusion levels were in agreement, shorter, or longer than those recommended by the Lenke classification or whether or not the recommendations for selective fusion of any of these classifications were adhered to. CONCLUSION: Lenke classification can save fusion levels without compromising on treatment outcomes when compared with PUMC classification. Variability in choice of distal fusion levels is not clinically significant at 24-month follow-up.
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spelling pubmed-81199052021-05-21 Choosing the Distal Fusion Levels in Lenke Type 1 Adolescent Idiopathic Scoliosis: How Do the Existing Classifications and Recommendations Guide Us? Garg, Bhavuk Mehta, Nishank Mukherjee, Rudra Narayan Global Spine J Original Articles STUDY DESIGN: Retrospective cohort. OBJECTIVE: (a) To compare the recommendations of Lenke and Peking Union Medical College (PUMC) classifications in choosing distal fusion levels in Lenke 1 adolescent idiopathic scoliosis (AIS) curves and (b) to analyze whether the variability in distal fusion levels influences treatment outcomes. METHODS: Hospital records of Lenke 1 AIS patients operated for single stage, posterior-only deformity correction were analyzed. Distal fusion levels recommended by Lenke and PUMC classifications were calculated and were compared with the actual distal fusion levels. The study population was divided based on whether the actual distal fusion levels were in agreement, shorter or longer than those recommended by Lenke classification. Subgroup analysis of Lenke 1C curves was done. The groups were compared with regard to the following outcome measures: Cobb angle correction, postoperative sagittal vertical axis, postoperative C7 offset, and Scoliosis Research Society–22r (SRS-22r) score at 24 months. RESULTS: The distal fusion levels recommended by the 2 classifications were in agreement in 92 of 104 cases. In all the cases with disparity, Lenke classification recommended shorter fusions than the PUMC classification. No statistically significant difference was observed in the outcome measures—whether the actual distal fusion levels were in agreement, shorter, or longer than those recommended by the Lenke classification or whether or not the recommendations for selective fusion of any of these classifications were adhered to. CONCLUSION: Lenke classification can save fusion levels without compromising on treatment outcomes when compared with PUMC classification. Variability in choice of distal fusion levels is not clinically significant at 24-month follow-up. SAGE Publications 2020-03-03 2021-05 /pmc/articles/PMC8119905/ /pubmed/32875882 http://dx.doi.org/10.1177/2192568220910712 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Articles
Garg, Bhavuk
Mehta, Nishank
Mukherjee, Rudra Narayan
Choosing the Distal Fusion Levels in Lenke Type 1 Adolescent Idiopathic Scoliosis: How Do the Existing Classifications and Recommendations Guide Us?
title Choosing the Distal Fusion Levels in Lenke Type 1 Adolescent Idiopathic Scoliosis: How Do the Existing Classifications and Recommendations Guide Us?
title_full Choosing the Distal Fusion Levels in Lenke Type 1 Adolescent Idiopathic Scoliosis: How Do the Existing Classifications and Recommendations Guide Us?
title_fullStr Choosing the Distal Fusion Levels in Lenke Type 1 Adolescent Idiopathic Scoliosis: How Do the Existing Classifications and Recommendations Guide Us?
title_full_unstemmed Choosing the Distal Fusion Levels in Lenke Type 1 Adolescent Idiopathic Scoliosis: How Do the Existing Classifications and Recommendations Guide Us?
title_short Choosing the Distal Fusion Levels in Lenke Type 1 Adolescent Idiopathic Scoliosis: How Do the Existing Classifications and Recommendations Guide Us?
title_sort choosing the distal fusion levels in lenke type 1 adolescent idiopathic scoliosis: how do the existing classifications and recommendations guide us?
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8119905/
https://www.ncbi.nlm.nih.gov/pubmed/32875882
http://dx.doi.org/10.1177/2192568220910712
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