NEW CLASSIFICATION SYSTEM IN AIS: IMPACT ON SURGERY
Journal Title: Journal of Turkish Spinal Surgery - Year 2003, Vol 14, Issue 1
Abstract
AIS CURVE CLASSIFICATION The King classification system has remained the principle means of classifying thoracic adolescent idiopathic scoliosis (AIS). Despite marked changes in the three-dimensional preoperative assessment and the use of segmental spinal instrumentation in the last decade, this coronal plane only system has prevailed, but has shortcomings. It is not comprehensive, uniplaner, and reliability of the system is suspect. As a direct reflection of a multi-center scoliosis group (Harms Scoliosis Study Group), difficulty with reproducible idiopathic scoliosis curve classification, a new system has been developed. Six goals in formulating this surgical system were specific from the outset: 1) to be comprehensive with all types of AIS curves classified; 2) to be two-dimensional with applicability to three-dimensional assessment; 3) to be treatment based; 4) to separate out specific curve types by objective radiographic criteria; 5) to be highly reliable; 6) to be logical, easily understood, and useful to scoliosis surgeons. There are three components to this new curve classification system: curve type, lumbar spine modifier, and a sagittal thoracic modifier. Each of these three components should be identified separately, then combined together to create the complete classification. Classification begins by reviewing the long cassette upright PA and lateral radiographs as well as right and left side bending radiographs. The spinal columns are divided into three regions: proximal thoracic (PT), main thoracic (MT), and thoracolumbar/lumbar (TL/L). one must also keep in mind the regional apices of curve designation with a main thoracic apex being located between the body of T2 inclusive to the T11-T12 disc; thoracolumbar curves having apices from the body of T12 to the body of L1 including the T12-L1 disc; and lumbar curves having apices extending from the L1-L2 disc to the body of L4 inclusive.
Authors and Affiliations
Lawrence G. LENKE, MD
Keywords
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