OBJECTIVE: To identify risk factors for postoperative distal decompensation (PDD) and safe surgical strategy in curvatures Lenke type 1A, treated with pedicle screws. METHOD: Retrospective radiographic study of 63 patients with scoliosis Lenke 1A, with follow-up of at least one year. The parameters evaluated were age, sex, degrees of Cobb's angle, Risser sign, relationship of distal instrumented vertebra (DIV) to the distal vertebra (DV) of the curvature, to the stable vertebra (SV) and to the vertebra which distance to the central vertical line to the sacrum (VLS) was greater than 10 mm of "vertebral distance" (VD). RESULTS: 8 cases (12.7%) developed DDP. The Risser sign was 0 in 2 patients (25%) and 1 in 2 patients (25%). DIV/DV relationship: 4 patients (50%) same level (DV +0), 4 patients (50%) caudal level (DV +1); DIV/SV ratio: 5 patients (62.5%) 2 cephalic levels (VD -2), 3 patients (37.5%) 1 cephalic level (SV -1); DIV/VD relationship: 5 patients (62.5%) 1 cephalic level (VD -1), 3 patients the same level (VD +0). CONCLUSIONS: Risk of postoperative distal decompensation: DIV same level DV (DV +0), 2 cephalic levels SV (SV -2), 1 cephalic level VD (VD -1). Surgical strategy in Lenke 1A curvatures: DIV: 1-2 levels caudal to DV (DV +1/+2), 1 cephalic level to SV (SV -1), the same level VD (VD +0).
Scoliosis, Idiopathic, Adolescent; Pedicular screws, Lenke Classification
