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Good Long-Term Outcomes With Selective Thoracic Fusion

Stable lumbar spinal balance and correction of lumbar curve in adolescent idiopathic scoliosis

TUESDAY, Oct. 11 (HealthDay News) -- Selective thoracic fusion for adolescent idiopathic scoliosis (AIS) yields long-term stable spinal balance and lumbar curve correction, with outcome measures comparable to long instrumented fusion, according to a study published online Sept. 30 in Spine.

A. Noelle Larson, M.D., from the University of Minnesota in Minneapolis, and colleagues investigated the long-term behavior of the lumbar curve in 19 patients with AIS treated with selective thoracic fusion, and compared the outcomes with nine patients with AIS treated with long fusion. At an average of 20 years postoperatively, the participants underwent radiographs, clinical evaluation, and outcome surveys (Short Form-12, Scoliosis Research Society-24, Spinal Appearance Questionnaire, Oswestry Disability Index, and Visual Analog Score for pain and stiffness).

The investigators found that the lumbar curve magnitude did not progress significantly, and L4 obliquity to the pelvis did not worsen between initial postoperative evaluation and the 20-year follow-up for the selective thoracic fusion group. Mean magnitude of pre-operative lumbar curve correction on initial postoperative films was 43 percent, compared to 38 percent at latest follow-up. Stable mean L4 obliquity to the pelvis, trunk shift, sagittal balance, and coronal balance were observed over time. There were similar outcome scores when comparing the two cohorts. There were significantly higher scores for Self-Image after Surgery and Function after Surgery in the long fusion group compared to the selective fusion group.

"Spinal balance and correction of the lumbar curve remain stable over time in selective thoracic fusion," the authors write.

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