The lumbosacral curve in idiopathic scoliosis. its significance and management
Fisk, J.R.; Winter, R.B.; Moe, J.H.
Journal of Bone and Joint Surgery. American Volume 62(1): 39-46
1980
ISSN/ISBN: 0021-9355 PMID: 7351414 Document Number: 154327
In 850 consecutive patients with idiopathic scoliosis, no primary lumbosacral curve with only secondary curves above it was found. Forty-four patients with double structural thoracic and lumbar, single structural thoracic, and single structural lumbar curves showed progressive loss of flexibility in the lumbosacral area. Of these, five patients had correction and fusion of the lumbosacral curve and seventeen had correction and fusion of the major curve above the third or fourth lumbar segment without surgical treatment of the lumbosacral area. The results were better in the latter group. Correction and fusion in the lumbosacral area was difficult to achieve. No patient had a permanent list when only curves above the lumbosacral curve were corrected and fused. Lumbosacral fusion should be reserved for primary lumbosacral curves associated with congenital anomalies or spondylolisthesis.