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Selection of posterior fixation segments for Lenke 5 adolescent idiopathic scoliosis – Lumbar Fusion

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The article discusses the controversy surrounding the surgical strategies for Lenke 5 adolescent idiopathic scoliosis. With advancements in spinal surgery, there is a growing understanding of three-dimensional correction, improved internal fixation instruments, de-rotation tools, and surgical techniques. The formulation of preoperative surgical strategies directly impacts the correction of deformity, balance reconstruction, activity function of the spine, and quality of life post-operation. The paper examines three aspects: the method of surgical fixation, the surgical approach, and the selection of fixed vertebrae. The author suggests considering Risser sign when deciding on the method of surgical fixation, taking into account the surgeon’s familiarity and experience with the surgical approach, and choosing safer options for the upper instrumented vertebra. The selection of the lower instrumented vertebra should be based on five factors

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

With the further understanding of the concept of three-dimensional correction by spinal surgeons, the progress of internal fixation instruments, de-rotation tools and the improvement of surgical techniques, the scientific formulation of surgical strategies for Lenke 5 adolescent idiopathic scoliosis has gradually become the focus of controversy. The formulation of preoperative surgical strategy not only directly affects the correction of deformity and balance reconstruction, but also is directly…

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Zhonghua Yi Xue Za Zhi. 2024 Jan 2;104(1):5-9. doi: 10.3760/cma.j.cn112137-20230803-00147.ABSTRACTWith the further understanding of the concept of three-dimensional correction by spinal surgeons, the progress of internal fixation instruments, de-rotation tools and the improvement of surgical techniques, the scientific formulation of surgical strategies for Lenke 5 adolescent idiopathic scoliosis has gradually become the focus of controversy.,

Zhonghua Yi Xue Za Zhi. 2024 Jan 2;104(1):5-9. doi: 10.3760/cma.j.cn112137-20230803-00147.

ABSTRACT

With the further understanding of the concept of three-dimensional correction by spinal surgeons, the progress of internal fixation instruments, de-rotation tools and the improvement of surgical techniques, the scientific formulation of surgical strategies for Lenke 5 adolescent idiopathic scoliosis has gradually become the focus of controversy. The formulation of preoperative surgical strategy not only directly affects the correction of deformity and balance reconstruction, but also is directly related to the activity function of spine and the quality of life of patients after operation. Therefore, this paper will discuss from three aspects: the method of surgical fixation, the surgical approach and the selection of fixed vertebrae. The author believes that Risser sign should be taken as an important consideration to judge the method of surgical fixation. The choice of surgical approach must refer to the operator’s familiarity and experience with the approach, grasp the adaptive signs and consider the risks and benefits of the operation, and choose the appropriate surgical approach according to the needs of different patients. The choice of fixed vertebrae, choosing upper end vertebra (UEV) as upper instrumented vertebra (UIV), is safer than the more radical upper end vertebra-1 (UEV-1), and five factors need to be combined in the specific selection of lower instrumented vertebra (LIV).

PMID:38178761 | DOI:10.3760/cma.j.cn112137-20230803-00147

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Selection of posterior fixation segments for Lenke 5 adolescent idiopathic scoliosis

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Zhonghua Yi Xue Za Zhi. 2024 Jan 2;104(1):5-9. doi: 10.3760/cma.j.cn112137-20230803-00147.ABSTRACTWith the further understanding of the concept of three-dimensional correction by spinal surgeons, the progress of internal fixation instruments, de-rotation tools and the improvement of surgical techniques, the scientific formulation of surgical strategies for Lenke 5 adolescent idiopathic scoliosis has gradually become the focus of controversy.
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