- See: Fusion to Sacrum:
- Indications for Rx:
- curves > 40-45 deg;
- documented progression;
- marked imbalance with a shift to one side;
- substantial pain;
- Operative Considerations:
- attempt to increase lordosis compared with that noted on preoperative lateral radiograph;
- in double major curves, the structural lumbar curve should be fused to L4 even if the L5 vertebra is included in the curve (assuming
that spondylolisthesis is not present);
- Pain due to low lumbar fusions occurs in:
- 80 % of patients w/ arthrodesis to L5;
- 60 % of patients w/ arthrodesis to L4;
- 40 % of patients w/ arthrodesis to L3;
- 30 % of patients w/ arthrodesis to L2;
- can also result in narrowing of spinal canal, causing secondary spinal stenosis to develop;
- Flat Back Syndrome:
- Caudad degeneration
The Galveston experience with L-rod instrumentation for adolescent idiopathic scoliosis.
Correction of degenerative scoliosis of the lumbar spine. A preliminary report.
The lumbosacral curve in idiopathic scoliosis. Its significance and management.
Adolescent idiopathic scoliosis. Long-term effect of instrumentation extending to the lumbar spine.