ABSTRACT

Study Design:

Retrospective single-center clinical study.

Objective:

We aimed to evaluate lumbar lordosis after posterior spinal fusion and bilateral segmental instrumentation for AIS. We also evaluated patients’ satisfaction with treatment.

Methods:

Twenty-two AIS patients treated with posterior spinal fusion and followed at least two years after the operation were evaluated retrospectively. Radiographic parameters for changes on frontal and sagittal planes were measured on anteroposterior and lumbar lordosis X-rays, and patients’ satisfaction was assessed by Scoliosis Research Society (SRS)-22r Patient Questionnaire preoperatively, at sixth month postoperatively, and at final visit which was at 43.6 months on average (range, 24-66 months).

Results:

The mean thoracic or thoracolumbar curve correction rate was 74.6±11.8%. The lumbar lordosis decreased from 51.3°±13.1° to 42.8°±12.6° (p=0.014) and sacral slope angle from 40.9°±5.7° to 27°±8.7° (p<0.001) after the operation. Mean pelvic tilt angle increased from 7.9°±7.6° to 20.2°±9.9° (p<0.001). Thoracic kyphosis was within normal limits and did not change significantly throughout the follow-up. Total SRS-22r score improved from 3.4±0.6 to 4±0.3 after AIS surgery.

Conclusions:

AIS surgery had no significant effect on throcal kyphosis and lumbar lordosis on sagittal plane; even insignificant decrease in lumbar lordosis reduces sacral slope, thus keeps sagittal C7 plumbline within normal limits, and as a result provides sagittal balance.