Neurospine.  2023 Sep;20(3):799-807. 10.14245/ns.2346452.226.

Selection of Optimal Lower Instrumented Vertebra for Adolescent Idiopathic Scoliosis Surgery

Affiliations
  • 1Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
  • 2Department of Neurosurgery, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea
  • 3Department of Neurosurgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea
  • 4Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Abstract

Adolescent idiopathic scoliosis (AIS) affects approximately 2% of adolescents across all ethnicities. The objectives of surgery for AIS are to halt curve progression, correct the deformity in 3 dimensions, and preserve as many mobile spinal segments as possible, avoiding junctional complications. Despite ongoing development in algorithms and classification systems for the surgical treatment of AIS, there is still considerable debate about selecting the appropriate fusion level. In this study, we review the literature on fusion selection and present current concepts regarding the lower instrumented vertebra in the selection of the fusion level for AIS surgery.

Keyword

Adolescent idiopathic scoliosis; Fusion level selection; Lower instrumented vertebra; Adding-on phenomenon
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