Thoracolumbar/lumbar adolescent idiopathic scoliosis functional and radiological results of treatment with posterior pedicle screws

Functional And Radiological Results Of Thoracolumbar / Lumbar Adolescent Idiopathic Scoliosis Treatment With Posterior Pedicle Screws The goal of thoracolumbar/lumbar AIS surgery should be to achieve good coronal and sagittal balance, while preserving more mobile spinal segments as possible. For this purpose, new classification systems are identified and 3D correction principles of the deformities are developed especially with the use of pedicle screws. Along with Lenke type 5C curvatures are defined as the curvatures that can be corrected with selective anterior and posterior fusions, decompensation and sagittal balance problems arising in time precipitate studies that reveal the causes of these problems recently. In our study, radiological parameters causing coronal imbalance in Lenke type 5C curvatures treated with posterior pedicule screws and fusion were studied, and their correlation with clinic were evaluated. Sixteen patient with Lenke type 5 C AIS operated between 2008-2015 years, were included in this study. 10 patients (62.5%) were female and 6 (37.5%) were male. The average age of the patients was 15.5 years and the mean follow up period was 37 months. The parameters affecting coronal and sagittal balance were measured on patients preoperative, postoperative and last control X-rays. Clinical satisfaction was assessed by the SRS-22 form (Turkish) in postoperative period. The fact that over 15 millimeters of global coronal balance was regarded as the coronal imbalance in early postoperative period. Patients were divided into 2 groups. Group 1 consisted of 8 patients with preserved coronal balance, and group 2 consisted of 8 patients with coronal imbalance. Radiological and clinical parameters of the groups were compared statistically in the early and late postoperative period. When patients' demographic datas and radiological parameters were compared, no statistical difference was observed between two groups. In the last control assessment in group 2, the major TL/L curvature, minor thoracic curvature, SVL, TAV translational amount and L4/5 disc angle were found to be significantly different (p<0.05). No statistical difference in terms of clinical outcomes were observed between 2 groups. In conclusion, we found that minor thoracic curvature, TAV translation and L4 / 5 disc angle have an impact on coronal balance in long-term, however no correlation was found between radiological coronal imbalance and clinical outcomes. Key words: Thoracolumbar/lumbar scoliosis, adolescent idiopathic scoliosis, coronal balance, L4/5 disc angle, posterior selective fusion