Lenke 1C, King type II curves: surgical recommendations

The objectives of this article are twofold. The first is to discuss the surgical experience in patients who have Lenke 1C (King type II) curves, including the experience with newer instrumentation. These patients present a significant challenge to the deformity surgeon because they have structural thoracic deformities and significant, but nonstructural, lumbar curves. Over the years, selective instrumentation and fusion of the thoracic curve have been the primary approach to preserve motion of the lumbar segments, and thus, improve the long-term outlook. This strategy has been undertaken with the expectation that the uninstrumented lumbar curve will allow for a well-balanced spinal column postoperatively. The second objective of this article is to present basic strategies that may be helpful when planning for surgery in these patients.