(based on classification of
King et al)
assistance provided by Ben Allen Jr. M.D.
- See:
Selection of Fusion Level:
- King Type I:
- S shaped or double curve with the lumbar curve larger and stiffer than the thoracic curve;
- this type of curve is usually fuse down to L4 (via a posterior approach) or down
to L3 (anterior approach);
- King Type II:
- double curve in which the thoracic curve is larger and stiffer than the lumbar;
- note that type II curves may be confused with a type III curve, but in the type II
lumbar curve should not cross the midline;
- often a thoracic fusion will suffice for these patients (or down to L1);
- type II curves may also be confused with doulble major curves;
- this confusion may occur when there is a thoracolumbar kyphosis in the saggital plane,
in which case fusion of both curves may be appropriate;
- King Type III:
- single thoracic curve w/ no compensatory lumbar curve which crosses the midline;
- managed w/ a thoracic fusion;
- King IV:
- long thoracic curve in which the L4 tilts to thoracic curve;
- fuse thru L4;
- King V:
-
double thoracic curve;
- T1 tilts to upper curve;
- fuse thru T2;
- do not assume that the upper (left) thoracic curve is non-structural without proof, and if
there is any question, fuse the upper thoracic spine as well as the lower thoracic spine;
The selection of fusion levels in thoracic idiopathic scoliosis.
Intraobersever and interobserver reliablitlity of the classification of thoracic adolescent idiopathic scoliosis.
LG Lenke etal.
JBJS. Vol 80-A. No 8. Aug 1998. 1097.
