Should All AIS 1C Curves Be Fused Selectively?

Area of Science:

• Orthopedics
• Spinal Surgery
• Scoliosis Research

Background:

• Idiopathic scoliosis, particularly Lenke 1C curves, presents a surgical challenge.
• Surgeons face a choice between selective thoracic fusion (STF) and nonselective fusion of thoracic and lumbar spines.
• Existing research on the outcomes of these surgical techniques yields mixed results.

Purpose of the Study:

• To compare the effectiveness of selective thoracic fusion (STF) versus nonselective fusion in treating idiopathic scoliosis with Lenke 1C curves.
• To evaluate spinal balance in both the thoracic and lumbar planes after each surgical approach.

Main Methods:

• Retrospective analysis of patient outcomes following STF and nonselective fusion for Lenke 1C idiopathic scoliosis.
• Assessment of spinal balance (decompensation) in thoracic and lumbar planes at a 2-year follow-up.

Main Results:

• Selective thoracic fusion (STF) resulted in 40% of patients experiencing 2 cm of decompensation after 2 years.
• Nonselective fusion demonstrated superior outcomes, with 89% of patients achieving balance in both thoracic and lumbar planes.
• The preoperative balance status did not significantly influence the postoperative balance in the nonselective fusion group.

Conclusions:

• Nonselective fusion of the thoracic and lumbar spines appears to be a more reliable surgical option for achieving long-term spinal balance in patients with idiopathic scoliosis and Lenke 1C curves.
• STF may lead to a higher risk of decompensation compared to nonselective fusion.
• Further research is warranted to fully elucidate the long-term implications and optimal surgical strategies for this patient population.