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KMID : 0361620070420030332
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Journal of the Korean Orthopaedic Association
2007 Volume.42 No. 3 p.332 ~ p.339
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Comparison of Proximal Fusion to T1 or T2 in Double Thoracic Adolescent Idiopathic Scoliosis
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Kim Jin-Hyok
Suk Se-Il
Kim Sung-Soo
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Abstract
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Purpose : To assess the results of double thoracic fusion using pedicle screw instrumentation fused proximally to T1 or T2 in patients with double thoracic adolescent idiopathic scoliosis (AIS).
Materials and Methods : Forty patients with double thoracic AIS were analyzed retrospectively after a minimum follow-up of 2 years. The patients were divided into two groups according to the proximal fusion level: the T1 group (n=26) was fused to T1 and the T2 group (n=14) was fused to T2.
Results : There were no significant differences in the preoperative curve characteristics between the two groups. In the T1 group, the preoperative upper curve magnitude of 38±7o and apical vertebral translation (AVT) of 8±6 mm were corrected to 17±7o (54% correction) and 4±3 mm (3 mm correction) at the final follow-up, respectively. In the T2 group, the preoperative upper curve magnitude of 37±5o and the AVT of 7±4 mm were corrected to 22±6o (42% correction) and 6±3 mm (1 mm correction) at the final follow-up, respectively. There was no difference in the correction of lower thoracic curve, sagittal alignment and balance between the two groups. There was a significantly better correction in the upper thoracic curve and T1 tilting in the T1 group than the the T2 group.
Conclusion : In double thoracic AIS, fusions to T1 and T2 produce satisfactory results. However, fusion to T1 is recommended for a better correction of the upper curve and T1 tilting.
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KEYWORD
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Idiopathic scoliosis, Double thoracic curve, Pedicle screw, Proximal fusion level
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