STEP 1
Curve Type 6
Thoracic curve non-structural, main thoracic curve structural, Lumbar curves major structural.
STEP 2
Lumbar modifier C
CSVL does not touch apex of lumbar curve
(apex - L1/2 disc)
STEP 3
Sagittal Modifier ( - )
T5-T12 in the <10o range
Therefore, Classification is Type 6C-
Lenke Type VI describes a major curve in the thoracolumbar/lumbar region with a structural main thoracic curve. The apex of the greatest coronal plane deformity is between T12 and L4; however, the main thoracic curve has a side-bending Cobb of greater than 25 degrees and a T10-L2 kyphosis of greater than 20 degrees. All of these curves have a “C” lumbar spine modifier. The three sagittal modifiers are still applicable. Most of these curves require instrumentation and fusion of both structural curves. The upper instrumented vertebra is between T2 and T4 depending on shoulder balance and the lower instrumented vertebra is usually L3 or L4. Selective fusion of only the thoracolumbar/lumbar region may be considered if the Cobb angle, apical vertebral translation, and apical vertebral rotation ratios (ThL/L:MT) are greater than 1.25.
Preop: 6C- Examples
Preop PA View
Preop LAT View
Preop LEFT Bend
Preop RIGHT Bend
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