European Spine Journal

, Volume 22, Issue 11, pp 2392–2398 | Cite as

Role of the upper and lowest instrumented vertebrae in predicting the postoperative coronal balance in Lenke 5C patients after selective posterior fusion

  • Zhen Liu
  • Jing Guo
  • Zezhang Zhu
  • Bangping Qian
  • Xu Sun
  • Leilei Xu
  • Yong QiuEmail author
Original Article



To investigate which pre- and postoperative radiographic parameters are significantly correlated with the immediate postoperative coronal balance (CB) in Lenke 5C AIS patients, and to identify any radiographic parameter that is correlated with the ultimate CB at a minimum follow-up of 2 years.


Forty Lenke 5C AIS patients were recruited in the current study. Preoperative, immediate postoperative, and the latest follow-up radiographs were reviewed measuring various radiographic parameters related to UIV and LIV. The correlations between different parameters and CB were then studied.


The average follow-up time was 35.2 months. Correlation analysis showed that the following radiographic parameters significantly associated with the immediate postoperative CB in Lenke 5C patients: preoperative CB (r = 0.66, p < 0.01), preoperative UIV translation (r = 0.61, p < 0.01), preoperative LIV tilt (r = 0.61, p < 0.01), postoperative UIV translation (r = 0.51, p < 0.05), and postoperative LIV tilt (r = 0.50, p < 0.05). At the last follow-up, only the final UIV tilt was inversely correlated with the ultimate CB (r = −0.58, p < 0.05). Seven patients presented with coronal imbalance immediately after surgery. However, only one of the seven patients presented with coronal imbalance at the last follow-up, and the other six achieved C7PL–CSVL distance within 10 mm.


In Lenke 5C patients, preoperative UIV translation and LIV tilt are two important parameters that can predict the immediate postoperative CB. During the postoperative follow-up, UIV tilt may play a very important role in compensating for postoperative coronal imbalance.


Idiopathic scoliosis Lenke type 5 curve Coronal balance Lowest instrumented vertebra Upper instrumented vertebra 



This work was supported by the National Public Health Benefit Research Foundation, China (Grant No. 201002018).

Conflict of interest

No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Zhen Liu
    • 1
  • Jing Guo
    • 1
  • Zezhang Zhu
    • 1
  • Bangping Qian
    • 1
  • Xu Sun
    • 1
  • Leilei Xu
    • 1
  • Yong Qiu
    • 1
    Email author
  1. 1.Spine SurgeryThe Affiliated Drum Tower Hospital of Nanjing University Medical SchoolNanjingChina

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