Transient fixation of L4 vertebra preserves lumbar motion and function in Lenke Type 5C and 6C scoliosis

Abstract This study investigated the efficacy of a novel surgical method that relies on the transient fixation of L4 in Lenke Type 5C and 6C adolescent idiopathic scoliosis. Thirty-six transient surgically treated L4 fixation patients were retrospectively evaluated. The first surgery involved mechan...

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Autores principales:	Jae-Ho Yang, Jae-Won Shin, Sub-Ri Park, Sun-Kyu Kim, Sang-Jun Park, Ji-Hwan Min, Byoung-Ho Lee, Kyung-Soo Suk, Jin-Oh Park, Seong-Hwan Moon, Hwan-Mo Lee, Hak-Sun Kim
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/b5fabc35c5174a61a796d6944e9036ce
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spelling	oai:doaj.org-article:b5fabc35c5174a61a796d6944e9036ce2021-12-02T17:15:24ZTransient fixation of L4 vertebra preserves lumbar motion and function in Lenke Type 5C and 6C scoliosis10.1038/s41598-021-89674-72045-2322https://doaj.org/article/b5fabc35c5174a61a796d6944e9036ce2021-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-89674-7https://doaj.org/toc/2045-2322Abstract This study investigated the efficacy of a novel surgical method that relies on the transient fixation of L4 in Lenke Type 5C and 6C adolescent idiopathic scoliosis. Thirty-six transient surgically treated L4 fixation patients were retrospectively evaluated. The first surgery involved mechanical correction of scoliosis; the lowest instrumented vertebra (LIV) was L4. After an average of 1.3 years (range, 0.3–3.4), the second surgery to remove transient L4 pedicle screws was performed. Radiographic parameters and SRS-22 scores were measured. Cobb’s angle, coronal balance, LIV tilting angle, and LIV coronal disc angle clearly improved after the first surgery (p < 0.01). After the second surgery, the corrected Cobb angle (p = 0.446) and coronal balance were maintained (p = 0.271). Although L3/S1 lumbar lordosis decreased after the first surgery (p < 0.01), after removal of transient L4 pedicle screws, it recovered slightly (p = 0.03). Similarly, the preoperative L3/4 lateral disc mobility eventually recovered after transient L4 screw removal (p < 0.01). The function domain of the SRS-22 showed better scores after removal of transient L4 screws (p = 0.04). L4 transient fixation surgery is beneficial for Lenke Type 5C and 6C scolioses that do not fully satisfy LIV (L3) criteria. It preserves L3/4 disc motion, increases functional outcomes, and maintains spinal correction and coronal balance.Jae-Ho YangJae-Won ShinSub-Ri ParkSun-Kyu KimSang-Jun ParkJi-Hwan MinByoung-Ho LeeKyung-Soo SukJin-Oh ParkSeong-Hwan MoonHwan-Mo LeeHak-Sun KimNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jae-Ho Yang Jae-Won Shin Sub-Ri Park Sun-Kyu Kim Sang-Jun Park Ji-Hwan Min Byoung-Ho Lee Kyung-Soo Suk Jin-Oh Park Seong-Hwan Moon Hwan-Mo Lee Hak-Sun Kim Transient fixation of L4 vertebra preserves lumbar motion and function in Lenke Type 5C and 6C scoliosis
description	Abstract This study investigated the efficacy of a novel surgical method that relies on the transient fixation of L4 in Lenke Type 5C and 6C adolescent idiopathic scoliosis. Thirty-six transient surgically treated L4 fixation patients were retrospectively evaluated. The first surgery involved mechanical correction of scoliosis; the lowest instrumented vertebra (LIV) was L4. After an average of 1.3 years (range, 0.3–3.4), the second surgery to remove transient L4 pedicle screws was performed. Radiographic parameters and SRS-22 scores were measured. Cobb’s angle, coronal balance, LIV tilting angle, and LIV coronal disc angle clearly improved after the first surgery (p < 0.01). After the second surgery, the corrected Cobb angle (p = 0.446) and coronal balance were maintained (p = 0.271). Although L3/S1 lumbar lordosis decreased after the first surgery (p < 0.01), after removal of transient L4 pedicle screws, it recovered slightly (p = 0.03). Similarly, the preoperative L3/4 lateral disc mobility eventually recovered after transient L4 screw removal (p < 0.01). The function domain of the SRS-22 showed better scores after removal of transient L4 screws (p = 0.04). L4 transient fixation surgery is beneficial for Lenke Type 5C and 6C scolioses that do not fully satisfy LIV (L3) criteria. It preserves L3/4 disc motion, increases functional outcomes, and maintains spinal correction and coronal balance.
format	article
author	Jae-Ho Yang Jae-Won Shin Sub-Ri Park Sun-Kyu Kim Sang-Jun Park Ji-Hwan Min Byoung-Ho Lee Kyung-Soo Suk Jin-Oh Park Seong-Hwan Moon Hwan-Mo Lee Hak-Sun Kim
author_facet	Jae-Ho Yang Jae-Won Shin Sub-Ri Park Sun-Kyu Kim Sang-Jun Park Ji-Hwan Min Byoung-Ho Lee Kyung-Soo Suk Jin-Oh Park Seong-Hwan Moon Hwan-Mo Lee Hak-Sun Kim
author_sort	Jae-Ho Yang
title	Transient fixation of L4 vertebra preserves lumbar motion and function in Lenke Type 5C and 6C scoliosis
title_short	Transient fixation of L4 vertebra preserves lumbar motion and function in Lenke Type 5C and 6C scoliosis
title_full	Transient fixation of L4 vertebra preserves lumbar motion and function in Lenke Type 5C and 6C scoliosis
title_fullStr	Transient fixation of L4 vertebra preserves lumbar motion and function in Lenke Type 5C and 6C scoliosis
title_full_unstemmed	Transient fixation of L4 vertebra preserves lumbar motion and function in Lenke Type 5C and 6C scoliosis
title_sort	transient fixation of l4 vertebra preserves lumbar motion and function in lenke type 5c and 6c scoliosis
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/b5fabc35c5174a61a796d6944e9036ce
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Transient fixation of L4 vertebra preserves lumbar motion and function in Lenke Type 5C and 6C scoliosis

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