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Observational analysis reveals surgical outcomes in idiopathic scoliosis with varying thoracic and lumbar curves, suggesting a targeted fusion approach.
In patients with combined thoracic and lumbar idiopathic scoliosis wherein the magnitude of the thoracic curve is equal to or greater than that of the lumbar curve and the lumbar curve is more flexible than the thoracic curve, the recommendation for surgical treatment is to correct and fuse only the thoracic curve (2). The rationale behind this selective thoracic correction/fusion strategy is to save as many mobile lumbar segments as possible, thereby reducing the risk of back pain and other low-back disorders associated with scoliosis fusions extending to the lower lumbar segments. The lumbar curve undergoes spontaneous correction when surgical correction of the thoracic curve is performed with the lower level of fusion properly selected (2).
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Patwardhan et al. (1995) studied this question.
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