Choosing fusion levels in adolescent idiopathic scoliosis.

Correct identification of fusion levels in surgical planning for the management of adolescent idiopathic scoliosis is a complex task. Several classification systems and algorithms exist to assist surgeons in determining the appropriate levels to be instrumented. The Lenke classification is the bench...

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Detalles Bibliográficos
Publicado en:Journal of the American Academy of Orthopaedic Surgeons Vol. 21; no. 9; pp. 519 - 529
Autores principales: Trobisch, Per David, Ducoffe, Aaron Rich, Lonner, Baron S, Errico, Thomas J
Formato: research review Journal Article
Publicado: Lippincott Williams & Wilkins Sep2013
Acceso en línea:Ver este registro en EBSCOhost
Descripción
Sumario:Correct identification of fusion levels in surgical planning for the management of adolescent idiopathic scoliosis is a complex task. Several classification systems and algorithms exist to assist surgeons in determining the appropriate levels to be instrumented. The Lenke classification is the benchmark system. Among the many factors and measurements that are taken into account when selecting the proper upper instrumented vertebra and lower instrumented vertebra are planning for selective fusion; preserving motion segments; preventing proximal and/or distal junctional kyphosis, shoulder imbalance, and neck pain; and maintaining short fusion lengths. Existing treatment algorithms do not account for every exception, and further research is required to improve long-term surgical outcomes.