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Relationship between lumbosacral transitional vertebra and postoperative outcomes of patients with Lenke 5C adolescent idiopathic scoliosis: a minimum 5-year follow-up study

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Abstract

Purpose

To assess the incidence of lumbosacral transitional vertebra (LSTV) in Lenke 5C adolescent idiopathic scoliosis (AIS) and evaluate the relationship between postoperative outcomes and LSTV when the lowest instrumented vertebra (LIV) is fixed at L3.

Methods

The study included 61 patients with Lenke 5C AIS who underwent fusion surgery of L3 as the LIV who were followed-up for a minimum of 5 years. Patients were divided into two groups: LSTV + and LSTV-. Demographic, surgical, and radiographic data, including L4 tilt and thoracolumbar/lumbar (TL/L) Cobb angle, were obtained and analyzed.

Results

LSTV was observed in 15 patients (24.5%). The L4 tilt was not significantly different between the two groups preoperatively (P = 0.54); however, it was significantly greater in the LSTV group postoperatively (2 weeks: LSTV +  = 11.7 ± 3.1, LSTV −  = 8.8 ± 3.2, P = 0.013; 2 years: LSTV +  = 11.5 ± 3.5, LSTV −  = 7.9 ± 4.1, P = 0.006; 5 years: LSTV +  = 9.8 ± 3.1, LSTV −  = 7.3 ± 4.5,  P= 0.042). The postoperative TL/L curve was greater in the LSTV + group, with significant differences at 2 weeks and 2 years postoperatively (preoperative: LSTV +  = 53.5 ± 11.2, LSTV −  = 51.7 ± 10.3,P = 0.675; 2 weeks: LSTV +  = 16.1 ± 5.0, LSTV- = 12.2 ± 6.6, P = 0.027; 2 years: LSTV +  = 21.7 ± 5.9, LSTV −  = 17.6 ± 5.9, P = 0.035; 5 years: LSTV +  = 18.7 ± 5.8, LSTV −  = 17.0 ± 6.1, P = 0.205).

Conclusion

The prevalence of LSTV in Lenke 5C AIS patients was 24.5%. Lenke 5C AIS patients with LSTV with the LIV at L3 had a significantly greater postoperative L4 tilt than those without LSTV and retained the TL/L curve.

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Data availability

The datasets analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors declare that there are no conflicts of interest in this study and there has no funding.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan

    Ippei Yamauchi, Hiroaki Nakashima, Masaaki Machino, Sadayuki Ito, Naoki Segi & Shiro Imagama

  2. Department of Orthopaedic Surgery, Meijo Hospital, Nagoya, Japan

    Ryoji Tauchi & Tetsuya Ohara

  3. Department of Orthopaedic Surgery, Ichinomiya Nishi Hospital, Ichinomiya, Japan

    Noriaki Kawakami

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  1. Ippei Yamauchi
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  2. Hiroaki Nakashima
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Correspondence to Hiroaki Nakashima.

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The authors declare that there are no conflicts of interest in this study and there has no funding.

Ethical approval

This study was conducted in compliance with the tenets of the Declaration of Helsinki and approved by the institutional review board of Nagoya University (No. 2016–0177).

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Yamauchi, I., Nakashima, H., Machino, M. et al. Relationship between lumbosacral transitional vertebra and postoperative outcomes of patients with Lenke 5C adolescent idiopathic scoliosis: a minimum 5-year follow-up study. Eur Spine J 32, 2221–2227 (2023). https://doi.org/10.1007/s00586-023-07752-y

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  • DOI: https://doi.org/10.1007/s00586-023-07752-y

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