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Selection of Fusion Level

- See: Treatment based on King et al Algorithm

- Discussion:
    - fusion mass needs to include distal vertebra of structural curve;
    - if a more distal vertebra appears rotated in the same direction as more cephalad vertebrae, it should be included in the fusion mass;
    - arthrodesis should include the first stable vertebra
          - this is the vertebrae that is bisceted by a line drawn thru the middle of the spinous process of S1 perpendicular to the iliac crest;
    - in low lumbar curves, avoid extending the fusion mass past L4;

- Radiographs:
    - lateral bending x-rays help delineate structural curves from compensatory curves which should not be included in the fusion mass

The selection of fusion levels in thoracic idiopathic scoliosis.