ArticleSpine deformity2023
Optimal lowest instrumented vertebra selection with consideration of coronal and sagittal planes to prevent distal junctional complications in patients with Lenke type 1A and 2A adolescent idiopathic scoliosis.
Article in Spine deformity, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed, 6 citations in OpenAlex.
- Intraoperative Radiographic Factors Related to Postoperative Distal Adding-On in Lenke Type 1A Adolescent Idiopathic Scoliosis.Spine surgery and related research · 2026Article
- Is fusion to the stable sagittal vertebra necessary to avoid distal junctional kyphosis in thoracic adolescent idiopathic scoliosis?Spine deformity · 2026Article
- Rod options to outcomes: comparing sagittal correction in pediatric posterior spinal fusion by rod size and material.Spine deformity · 2025Article
- Impact of Sagittal Reference Lines on Predicting Distal Junctional Kyphosis in Adolescent Idiopathic Scoliosis.Orthopaedic surgery · 2025Article
- Selection of Lower instrumented vertebra in early-onset scoliosis at index growth rod insertion- can we predict distal add-on at graduation surgery?Journal of craniovertebral junction & spineArticle
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Authors and funding
11 authors at 1 institution in 1 country.
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Abstract
purposePostoperative distal adding-on and distal junctional kyphosis are major distal junctional complications after selective thoracic fusion in patients with adolescent idiopathic scoliosis (AIS). This study aimed to investigate the incidence of distal adding-on and distal junctional kyphosis and evaluate the validity of our selection criteria for the lowest instrumented vertebra (LIV) in patients with Lenke type 1A and 2A AIS.
methodsWe retrospectively analyzed the data of patients with Lenke type 1A and 2A AIS, who underwent posterior fusion surgery. LIV selection included the followings: (1) stable vertebra on traction film, (2) disc space neutralization below the LIV on the side-bending film, and (3) lordotic disc below the LIV on the lateral film. Radiographic parameters and the revised 22-item Scoliosis Research Society Questionnaire (SRS-22r) were evaluated. The incidence of postoperative distal adding-on and distal junctional kyphosis was also investigated.
resultsNinety patients (83 women and 7 men; 64 with type 1A and 26 with type 2A) were included. After the operation, each curve and the SRS-22r of self-image, mental health, and subtotal domains were significantly improved. Distal adding-on occurred in three patients (3.3%, one in type 1A and two in type 2A) at 2 years postoperatively. No patients exhibited distal junctional kyphosis.
conclusionsOur LIV selection criteria could reduce the incidence of postoperative distal adding-on and distal junctional kyphosis in patients with Lenke type 1A and 2A AIS. LEVEL OF EVIDENCE: Level IV.
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