Adolescent idiopathic scoliosis with Lenke type V and VI curves: possibilities of modern segmental instrumentation

Objective. To analyze long-term results of surgical correction and postoperative quality of life in patients with Lenke type V and VI de- formities of the spine. Material and Methods. The treatment results of 61 patients (average age 15 years) with Lenke type V–VI spinal deformities and mean follow-up period of 3.3 years were analyzed. The average length of anterior fusion was 12.7 segments. The average length of the primary curve instrumented with pedicle screws was 4.9 segments. Results. The primary curve was 56.6°, after surgical intervention it was reduced to 15.1° (73.3 % correction). Postoperative progression within 3.3 years was 2.1°. Thoracic countercurve was 40.6°, after surgery it was corrected to 15.0° (63.0 % correction). At the final follow- up examination, the thoracic curve was 17.3° (progression 2.3°). Thoracic kyphosis and lumbar lordosis were within the normal ranges. The frontal imbalance was 22.1 mm before surgery and 12.2 mm at the final follow-up examination. The SRS-24 questionnaire data showed a significant score increase in all seven domains. Conclusion. Transpedicular fixation allows achieving a high degree of Lenke type V–VI spinal deformity correction with a stable result and significant improvement in the quality of life of patients.