Transient fixation of L4 vertebra preserves lumbar motion and function in Lenke Type 5C and 6C scoliosis

Jae Ho Yang, Jae Won Shin, Sub Ri Park, Sun Kyu Kim, Sang Jun Park, Ji Hwan Min, Byoung Ho Lee, Kyung Soo Suk, Jin Oh Park, Seong Hwan Moon, Hwan Mo Lee, Hak Sun Kim

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This study investigated the efficacy of a novel surgical method that relies on the transient fixation of L4 in Lenke Type 5C and 6C adolescent idiopathic scoliosis. Thirty-six transient surgically treated L4 fixation patients were retrospectively evaluated. The first surgery involved mechanical correction of scoliosis; the lowest instrumented vertebra (LIV) was L4. After an average of 1.3 years (range, 0.3–3.4), the second surgery to remove transient L4 pedicle screws was performed. Radiographic parameters and SRS-22 scores were measured. Cobb’s angle, coronal balance, LIV tilting angle, and LIV coronal disc angle clearly improved after the first surgery (p < 0.01). After the second surgery, the corrected Cobb angle (p = 0.446) and coronal balance were maintained (p = 0.271). Although L3/S1 lumbar lordosis decreased after the first surgery (p < 0.01), after removal of transient L4 pedicle screws, it recovered slightly (p = 0.03). Similarly, the preoperative L3/4 lateral disc mobility eventually recovered after transient L4 screw removal (p < 0.01). The function domain of the SRS-22 showed better scores after removal of transient L4 screws (p = 0.04). L4 transient fixation surgery is beneficial for Lenke Type 5C and 6C scolioses that do not fully satisfy LIV (L3) criteria. It preserves L3/4 disc motion, increases functional outcomes, and maintains spinal correction and coronal balance.

Original languageEnglish
Article number10192
JournalScientific reports
Issue number1
Publication statusPublished - 2021 Dec

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© 2021, The Author(s).

All Science Journal Classification (ASJC) codes

  • General


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