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. 2023 Jan;13(1):219-226.
doi: 10.1177/21925682221091744. Epub 2022 Apr 8.

Is it Safe to Save Levels and Choose the Lowest Instrumented Vertebra as Touched Vertebra While Selectively Fusing Lenke 1/2 Curves? A Proportional Meta-Analysis of Existing Evidence

Syed Ifthekar  1 , Kaustubh Ahuja  1 , Pudipeddi Venkata Sudhakar  1 , Samarth Mittal  1 , Gagandeep Yadav  1 , Pankaj Kandwal  1 , Bhaskar Sarkar  1 , Nikhil Goyal  1
Affiliations

Is it Safe to Save Levels and Choose the Lowest Instrumented Vertebra as Touched Vertebra While Selectively Fusing Lenke 1/2 Curves? A Proportional Meta-Analysis of Existing Evidence

Syed Ifthekar et al. Global Spine J. 2023 Jan.

Abstract

Study design: Meta-analysis.

Objective: To compare the clinical and radiological outcomes in patients with Adolescent Idiopathic scoliosis (AIS) treated by selective thoracic fusion (STF) with lowest instrumented vertebra (LIV) at touched vertebra (TV) vs stable vertebra (SV).

Methods: The databases PubMed, Embase and Google Scholar were searched until November 2020.Studies which had Lenke type 1 curves and Lenke type 2 curves in adolescent population treated by STF and which reported pre- and post-operative curve characteristics including correction percentage and complications were included. Studies which did not report the LIV selection, curve correction percentages and whose full text could not be acquired were excluded.

Results: Eight studies were included for analysis of which seven were found to be retrospective studies (level III evidence) and one was prospective study (level II evidence) each. Overall proportional meta-analysis found no significant difference in correction rate, total srs-22 scores, and complication rates.

Conclusion: The evaluation of SV group and TV group as LIV for selective thoracic fusions in AIS reveals a comparable outcome in terms of curve correction, patient satisfaction scores and complication rates. The TV can be chosen safely as the LIV especially in type A and B Lenke 1&2 curves, as it saves more motion segments when compared to SV.

Keywords: Lenke 1 & 2 curves; Selective thoracic fusion; Stable vertebra; Touched vertebra; adolescent idiopathic scoliosis.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
PRISMA flowchart showing the selection of studies for the meta-analysis.
Figure 2.
Figure 2.
Proportional meta-analysis comparing the curve correction rates between the two groups.
Figure 3.
Figure 3.
Proportional meta-analysis comparing the complications between the two groups.
See this image and copyright information in PMC

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