Sponseller, Paul D. MD*; Flynn, John M. MD†; Newton, Peter O. MD‡; Marks, Michelle C. MA, PT‡; Bastrom, Tracey P. MA‡; Petcharaporn, Maty BS‡; McElroy, Mark J. MS*; Lonner, Baron S. MD§; Betz, Randal R. MD‖; the Harms Study Group
Study Design. Retrospective review.
Objective. To determine the association of patient characteristics and spinal curve parameters with Lenke curve types.
Summary of Background Data. The Lenke curve classification may be used for surgical planning and clinical research.
Methods. We retrospectively reviewed the records of 1912 patients with adolescent idiopathic scoliosis who underwent initial surgery at 21 years of age or younger; collected data on patient’s age, patient’s sex, primary curve magnitude (<50°, 50°–75°, and .75°), and Scoliosis Research Society (SRS) outcomes questionnaire (SRS-22) score; and compared that data by Lenke curve type. Analysis of variance and χ2 tests were used as appropriate (significance level, P ≤ 0.005).
Results. Lenke types vary by sex: male patients had more major thoracic (types 1–4) than major thoracolumbar/lumbar (types 5 and 6) curves, fewer lumbar C-modifiers (32% vs. 44%), and less apical lumbar translation (1.1 vs. 1.7 cm). Lenke types vary by frequency: the most common type was 1 (50%); the least common, 4 (4%). Lenke types vary by magnitude: type 4 had the greatest percentage of large curves (52% of curves .75°), most smaller curves were types 1 and 5, and type 4 had the largest mean magnitude (78° ± 17°). Lenke types vary by patient age: type 5 curves occurred in the oldest patients (average age at surgery: 15.4 ± 2.2 vs. 14.3 ± 14.6 years for all others) despite having the lowest mean magnitude (P = 0.001); curve size was negatively correlated with age at surgery (r = −0.16, P = 0.001). Lenke types vary by patient self-image: patients with type 4 curves had lower preoperative SRS outcome scores for self-image than did patients with type 1 curves (P = 0.005).
Conclusion. Lenke types vary by sex, frequency magnitude, patient age, and patient self-image, which should be considered in designing studies.
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Spine: 01 June 2012 – Volume 37 – Issue 13 – p 1138–1141