Selective Fusion in Lenke 1 B/C: Before or After Menarche?

Abstract

Study Design: A retrospective, comparative study. Objective: To determine the radiological behavior of the lumbar curve in selective fusions in premenarchal girls with adolescent idiopathic scoliosis (Lenke 1 B/C). Methods: A retrospective, comparative study was conducted. Selective fusion was performed in 21 patients younger than 18 years. The patients were divided into 2 groups: group A, after menarche (n = 12) and group B, before menarche (n = 9). Angles (preoperative, and at 1 and 2 years postoperatively) of the fused thoracic curves and the corresponding lumbar curves were measured and compared. For statistical analysis, the t test was used with a significance level of P < .05. Results: Mean preoperative angle value of the proximal/main thoracic curve was 61° in group A and 57° in group B ( P = .44), and 21° and 20°, respectively, in the first year postoperatively ( P = .61). Mean preoperative angle value of the lumbar curve was 43° in group A and 42° in group B ( P = .87), while at 1 year after surgery, this curve was 19° in both groups ( P = 0.91), and at 2 years postoperatively, the curve was 16° in group A and 17° in group B ( P = .75). Conclusions: Over a 2-year follow-up, we did not find significant radiological differences in lumbar curves between patients who underwent surgery before and after menarche.

Subjective perception of spinal deformity after selective versus non-selective fusion of Lenke 1C curves

“…Koller et al, in an interesting multicentre prospective database study recruiting 410 AIS patients, established an accurate prediction model for postoperative spontaneous lumbar curve correction, in patients undergoing selective STF [ 12 ]. Finally, Davies et al, in a retrospective comparative study recruiting 21 AIS patients, have found no significant radiological differences in lumbar curves between patients who underwent STF before and after menarche, at 2-year follow-up [ 14 ].…”

“…Although in recent years, several studies [9,[12][13][14] have attempted to identify preoperative radiologic factors able to predict the successful outcome of STFs, none of the previous studies, to the authors' knowledge, has focused on the body's image perception in adolescents undergoing posterior STF, compared with non-selective fusion (N-STF).…”