| Objective:To investigate the strategy of selecting the upper instrumented vertebra(UIV) in adult degenerative scoliosis.Material and methods:A retrospective study was conducted with medical records and long cassette radiographs of adult degenerative scoliosis patients who underwent posterior spinal fusion from2010to2013in our hospital.21patients were enrolled in this research,including9cases in group A (the UIV was lower than T10) and12cases in group B (the UIV was T10or higher than T10). Radiographic measurement included Cobb angles of thoracolumbar scoliosis, C7PL-CSVL,SVA,LL, clavicle angle.Result:The preoperative Cobb angles of thoracolumbar scoliosis of group A and group B were21.81±11.25°and29.97±13.93°, which were significantly (P<0.05and P<0.05) corrected to5.96±3.08°and10.61±8.08°with the correction of66.22±19.63%and65.92±22.23%(P>0.05). The preoperative and postoperative Cobb angles of thoracolumbar scoliosis between group A and group B were found no statistical difference (P>0.05). The preoperative C7-CSVL of group A and group B were19.52±11.73mm and25.69±17.20mm,which were significantly (P<0.05and P<0.05) corrected to13.17±8.83mm and16.62±13.02mm. The preoperative and postoperative C7-CSVL between group A and group B were found no statistical difference (P>0.05). There were no statistical difference (P>0.05) between preoperative clavicle angles (2.94±3.25°and3.52±2.65°) and postoperative clavicle angles (1.88±1.94°and3.76±3.16°) of group A and group B. There were no statistical difference (P>0.05) between preoperative LL (37.34±16.53°) and postoperative clavicle angles (37.35±12.11°) of group A.However, the postoperative LL (43.44±7.35°) were significantly (P<0.05) larger than the preoperative(33.81±14.00°), No statistical difference (P>0.05) were found in preoperative LL between group A and group B.The postoperative LL of group B is significantly (P<0.05) larger than group A. The preoperative SVA of group A and group B were36.54±26.03mm and51.15±51.18mm,which were significantly (P<0.05and P<0.05) corrected to19.67±12.14mm and35.21±34.14mm. The preoperative and postoperative SVA between group A and group B were found no statistical difference (P>0.05).Conclusion:When treating the ADS patient by posterior spinal fusion, selecting T10or higher than T10as UIV provides a better correction on LL. Further research is required to confirm the definite and long-term effect of our result. |
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