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Lowest Instrumented Vertebra at L3 Versus L4 in Posterior Fusion for Moderate Lenke 5C Type Adolescent Idiopathic Scoliosis: A Case-Match Radiological Study – Lumbar Fusion

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The article titled “Comparative Study of Radiological Outcomes in Lenke 5C Type Patients with L3 or L4 as the Lowest Instrumented Vertebra” analyzes the radiological outcomes of patients with Lenke 5C type adolescent idiopathic scoliosis (AIS) who had their lowest instrumented vertebra (LIV) at either L3 or L4. The study included 82 patients and compared the radiological results before surgery, after surgery, and at the last follow-up. After matching for age, Risser’s sign, sex, and main Cobb, 41 pairs of patients were enrolled in the study. The results showed that the total fusion segments in the L3 group were shorter than those in the L4 group. However, the correction in the main curve was significant after surgery in both groups and was comparable at the last follow-up. Furthermore, there was no significant difference in coronal or sagittal imbalance between the two groups at the 2-year follow-up. The study suggests that L3 could be an ideal choice as the LIV in moderate Lenke 5C type AIS due to the presence of more motion segments, but long-term follow-up is needed to evaluate the effect of a larger compensatory lumbar-sacral curve when stopping at L3

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Published article

: The correction in coronal and sagittal planes in L3 group and L4 group remains similar. On account of more motion segments, L3 could be an ideal choice as LIV in moderate Lenke 5C type AIS. Long-term follow-up is needed to evaluate the effect of larger compensatory lumbar-sacral curve when stopping at L3.

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Neurospine. 2023 Dec;20(4):1380-1388. doi: 10.14245/ns.2346822.411. Epub 2023 Dec 31.ABSTRACTOBJECTIVE: To compare the radiological outcomes in Lenke 5C type patients whose lowest instrumented vertebra (LIV) was L3 or L4 in a case-match study.METHODS: We conducted a retrospective case-match study and included 82 patients in the study. Radiological results before surgery, after surgery, and at last follow-up,

Neurospine. 2023 Dec;20(4):1380-1388. doi: 10.14245/ns.2346822.411. Epub 2023 Dec 31.

ABSTRACT

OBJECTIVE: To compare the radiological outcomes in Lenke 5C type patients whose lowest instrumented vertebra (LIV) was L3 or L4 in a case-match study.

METHODS: We conducted a retrospective case-match study and included 82 patients in the study. Radiological results before surgery, after surgery, and at last follow-up were recorded and analyzed in the L3 and L4 groups.

RESULTS: After matching the age, Risser’s sign, sex, and main Cobb, 41 pairs of patients were enrolled in our study. The total fusion segments in the L3 group (median [interquartile range]: 5.0 [6.0-5.0]) were shorter than those in the L4 group (6.0 [6.5-6.0]). The main curve was significantly corrected after surgery in both groups, and was comparable at the last followup between groups. In addition, according to the results of Fisher precision probability test, there was no significant difference of coronal or sagittal imbalance between the 2 groups at the 2-year follow-up.

: The correction in coronal and sagittal planes in L3 group and L4 group remains similar. On account of more motion segments, L3 could be an ideal choice as LIV in moderate Lenke 5C type AIS. Long-term follow-up is needed to evaluate the effect of larger compensatory lumbar-sacral curve when stopping at L3.

PMID:38171304 | DOI:10.14245/ns.2346822.411

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Lowest Instrumented Vertebra at L3 Versus L4 in Posterior Fusion for Moderate Lenke 5C Type Adolescent Idiopathic Scoliosis: A Case-Match Radiological Study

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Neurospine. 2023 Dec;20(4):1380-1388. doi: 10.14245/ns.2346822.411. Epub 2023 Dec 31.ABSTRACTOBJECTIVE: To compare the radiological outcomes in Lenke 5C type patients whose lowest instrumented vertebra (LIV) was L3 or L4 in a case-match study.METHODS: We conducted a retrospective case-match study and included 82 patients in the study. Radiological results before surgery, after surgery, and at last follow-up

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