METHODS: The study included 36 patients who underwent surgical treatment in our institution for a diagnosis of Lenke type 5 and 6 AIS with a follow-up period of at least 24 months. The patients were separated into 2 groups according to the LIV level of L3 (n=21) and L4 (n=15). These 2 groups were compared preoperatively (PO), early postoperative (EPO), and at the final follow-up examination (last control (LC)) with respect to radiological parameters in the coronal and sagittal planes, and the Scoliosis Research Society - 22 (SRS-22) questionnaire values.
RESULTS: In both groups the mean age (L3: 16 ± 7.3; L4: 17 ± 6.1 years) and follow-up periods (L3: 44 ± 20; L4: 47 ± 18 months) were similar. Radiologically, the L4 group had a greater Cobb angle in the scoliosis main curves measured PO (P=.001). The Cobb angles measured at EPO (P=.767) and at LC (P=.674) were similar in both groups. No significant difference was observed between the 2 groups in respect of the LIV tilt values at PO (P=.469), EPO (P=.297), and LC (P=.065). When the groups were evaluated separately, the LIV tilt values at EPO and LC were similar in the L4 group (EPO: 6.93 ± 3.058; LC: 7.26 ± 2.313; P=.618). In the L3 patients, although there seemed to be a significant increase in LIV tilt values when EPO values were compared with LC values (EPO: 8.47 ± 3.970; LC: 9.57 ± 3.76; P=.030), this was within the error range of Cobb angle measurement. The results of the SRS-22 questionnaire showed significantly better results in the L3 group in the domains of pain, function/activity, mental health, and satisfaction with treatment (P=.011, P=.002, P=.019, P=.046, respectively).
CONCLUSIONS: There was no radiological superiority between L3 and L4 LIV groups in the thoracolumbar/lumbar curve patients. However, according to the SRS-22 questionnaire, the results of patients with L3 level LIV were better in the areas of pain, function/activity, mental health, and satisfaction with treatment. Cite this article as: Baymurat AC, Tokgoz MA, Abdulaliyev F, Tosun MF, Can MM, Senkoylu A. Which lumbar vertebra should be the lowest level of fusion in adolescent idiopathic scoliosis of Lenke types 5 and 6? Acta Orthop Traumatol Turc., 2024;58(2):116-123.
方法:该研究包括36例患者,这些患者在我们机构接受手术治疗,诊断为Lenke5型和6型AIS,随访期至少24个月。根据L3(n=21)和L4(n=15)的LIV水平将患者分为2组。两组术前(PO)比较,术后早期(EPO),在最后的随访检查(最后一次控制(LC))中,关于冠状面和矢状面的放射学参数,和脊柱侧弯研究学会-22(SRS-22)问卷值。
结果:两组的平均年龄(L3:16±7.3;L4:17±6.1岁)和随访时间(L3:44±20;L4:47±18个月)相似。放射学上,L4组在测量的脊柱侧凸主曲线中具有较大的Cobb角(P=.001)。两组在EPO(P=0.767)和LC(P=0.674)下测得的Cobb角相似。在PO时的LIV倾斜值方面,两组之间没有观察到显着差异(P=0.469),EPO(P=.297),和LC(P=.065)。当分别对各组进行评估时,L4组EPO和LC的LIV倾斜值相似(EPO:6.93±3.058;LC:7.26±2.313;P=.618).在L3患者中,尽管将EPO值与LC值进行比较时,LIV倾斜值似乎显着增加(EPO:8.47±3.970;LC:9.57±3.76;P=.030),这在Cobb角测量的误差范围内。SRS-22问卷的结果显示,L3组在疼痛领域的结果明显更好,功能/活动,心理健康,和对治疗的满意度(分别为P=.011,P=.002,P=.019,P=.046)。
结论:在胸腰椎/腰椎曲线患者中,L3和L4LIV组没有放射学优势。然而,根据SRS-22调查问卷,L3水平LIV的患者在疼痛方面的结果更好,功能/活动,心理健康,以及对治疗的满意度。引用这篇文章:BaymuratAC,TokgozMA,AbdulaliyevF,TosunMF,可以MM,SenkoyluA.Lenke5型和6型青少年特发性脊柱侧凸的融合水平最低的腰椎应该是哪一个?ActaOrthopTraumatolTurc。,2024;58(2):116-123。