Other

SELECTION OF FUSION AREA İN THE SURGICAL TREATMENT OF KING TYPE II CURVES

  • Azmi HAMZAOGLU
  • Cüneyt ŞAR
  • Ünsal DOMANİÇ
  • Bora GÖKSAN

J Turk Spinal Surg 1993;4(3):98-101

One of the most important problems with instrumentations doing 3D correction in the surgical treatment of idiopathic scoliosis is decompensation which especially develops following selective thoracic fusion performed for King type II curves.

Between 1990 and 1993, in our clinic selective thoracic fusion and instrumentation vvas performed in 19 (15.4%) of 26 (21.1%) cases with King Type II curves out of 123 surgically treated idiopathic scoliosis pa-tients.

İn the selection of fusion area, standing Standard AP and lateral radiograps, supine bending radiographs and sometimes traction radiographs at Risser table were taken. in the selection of distal fusion level, stable and neutral vertebra was used and intraoperative X-rays were taken to avoid overcorrection of the curve.

Mean follow-up vvas 16 months (min 6 months, max. 3 years). There vvas no postoperative decompensation in any of King Type II cases, who had selective thoracic fusion. İn cases vvith Risser 0-1 (immature), a brace vvas used postoperatively for the lovver curve.

We think that, in King type II curves, it is sufficient to end the fusion at stable and neutral vertebra when the flexibility of the lumbar curve is över 50% and in absence of kyphotic deformity at the thoracalumbar junc-tion. İn these cases, no decompensation is seen when the amount of correction of the thoracic curve does not exceed the flexibility of the lumbar curve seen on preoperative bending radiographs.

Our results confirm the validity of selective thoracic fusion for King Type II curves.

Keywords: Selective fusion, thoracic curve, idiopathic scoliosis.