Predictors of spontaneous lumbar curve correction in thoracic-only fusions: 3D analysis in AIS
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Predictors of spontaneous lumbar curve correction in thoracic‑only fusions: 3D analysis in AIS Dylan Kluck1 · T. Barrett Sullivan1 · Tracey P. Bastrom2 · Carrie E. Bartley2 · Burt Yaszay1,2 · Peter O. Newton1,2 Received: 21 February 2020 / Accepted: 14 October 2020 © Scoliosis Research Society 2020
Abstract Purpose To evaluate how 3D parameters of the instrumented thoracic spine relate to the uninstrumented lumbar spine following thoracic-only fusion (TOF) for adolescent idiopathic scoliosis (AIS) and determine the factors predictive of lumbar correction. Methods A multi-center retrospective review was conducted of AIS patients with Lenke 1–4 B or C curves undergoing fusion of their thoracic spine only with minimum 2-year follow-up and 3D spine reconstructions from biplanar radiography. Pre-operative to 2-year post-operative differences were evaluated. Pearson’s correlations were used to identify 3D coronal, sagittal and axial relationships at 2 years post-operative. Multivariate linear regression was used to identify variables most predictive of lumbar curve correction. Results Eighty-four AIS patients met inclusion (54 B modifiers, 30 C modifiers). Average pre-operative thoracic and lumbar curves were 54 ± 9° and 41 ± 7° and corrected to 19 ± 7° and 21 ± 7°, respectively. 3D T5-T12 thoracic kyphosis increased from 6 ± 13° to 26 ± 8°. Thoracic and lumbar apical rotation decreased from − 14 ± 6° to -5 ± 6° and 13 ± 5° to 11 ± 6°, respectively. Thoracic curve correction correlated with lumbar curve correction (r = 0.67, p = 0.001) and decreased LIV tilt correlated with smaller residual lumbar curve magnitude (r = 0.63, p
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