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Purpose of study: To determine the usefulness of the treatment recommendation criteria given by the Lenke classification for treatment of idiopathic scoliosis. Methods used: One hundred eighty-three patients with idiopathic scoliosis and with a minimum follow-up period of 24 months were included in the study and classified according to the Lenke system. Among these patients, 135 patients were treated with fusion and instrumentation in accordance with the Lenke recommendations and are described as Group 1. The 48 patients whose treatments do not follow the recommendation of the Lenke system constitute Group 2. These two groups were compared in regard to the correction of the Cobb angle and the trunk shift after surgery in order to establish the effectiveness and reliability of the treatment recommendations described by Lenke. of findings: Type 1 primary thoracic curve: There was no difference between the results from the group with selective thoracic fusion (Group 1) and from the group with both thoracic and lumbar curves fused (Group 2). Type 2 double thoracic scoliosis: The correction of the upper thoracic curve, the first thoracic vertebral tilt and left shoulder elevation were better in the group with both thoracic curves fused (Group 1) than in the group with midthoracic fusion (Group 2). Type 3 double major scoliosis: The lumbar curve correction was better in the group with both thoracic and lumber curves fused (Group 1) than in the group with selective thoracic fusion (Group 2), and decompensation occurred more frequently in Group 2. Type 4 triple major scoliosis: Because there were only two patients with this type of curve, no analysis was completed. Type 5 thoracolumbar or lumbar curve: There was no difference between the results from the group with selective thoracolumbar or lumbar fusion (Group 1) and the group with thoracic and lumbar curves fused (Group 2). Type 6 double major scoliosis with larger lumbar curve: The thoracic curve correction was better in the group with both curves fused (Group 1) than in the group with only the lumbar curve fused (Group 2). Relationship between findings and existing knowledge: Recent studies [1,2] have proven that the Lenke system regarding curve classification is relatively efficient and consistent. However, before this study, the recommendations regarding the selection of fusion levels had yet to be established as reliable. In our evaluation, we were able to achieve better clinical and radiological results when following the treatment recommendations proposed by Lenke than when the treatment did not coincide with that of Lenke. Therefore, based on our findings, Lenke classification seems to be a valuable tool in the selection of fusion levels. Overall significance of findings: In the surgical treatment of spinal deformity, the importance of adequate curve correction, maintenance of trunk balance and saving motion segments cannot be overemphasized. This study proved that by following the recommendations of Lenke, these goals can be achieved. Additionally, our results show that the use of these treatment recommendations helps surgeons avoid unnecessary fusion of the lumbar or thoracic spine in certain curve types. Disclosures: No disclosures. Conflict of interest: No conflicts. [ABSTRACT FROM AUTHOR]