ArticleSpine deformity2026
Utilization of posterior column osteotomies with posterior spinal fusion for correction of Lenke type 5 adolescent idiopathic scoliosis: a systematic review.
Article in Spine deformity, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPosterior spinal fusion (PSF) is a common treatment for Lenke type 5 adolescent idiopathic scoliosis (AIS). Posterior column osteotomies (PCOs) can be added to increase flexibility and facilitate deformity correction, but their routine value in thoracolumbar/lumbar curves remains unclear. This systematic review therefore evaluates the utilization of PCOs in published Lenke 5 AIS literature, comparing radiographic outcomes of PSF with versus without PCOs.
methodsA systematic review was performed according to PRISMA guidelines. Medline, Embase, and Cochrane were searched from inception through December 2025 for studies evaluating Lenke 5 AIS treated with posterior thoracolumbar/lumbar fusion with or without PCOs. Eligible studies reported preoperative and postoperative coronal and sagittal radiographic measurements. Descriptive pooled means and standard deviations were calculated, and between-group comparisons were performed on pre-to-post radiographic changes.
results35 studies met inclusion criteria, analyzing 2108 patients. PCOs were used in 21.7% of pooled patients: 5 studies (490 patients) evaluated PSF + PCO and 30 studies (1618 patients) evaluated PSF alone. Mean thoracolumbar/lumbar Cobb correction was 79.22% in PCO cohorts versus 74.07% in non-PCO cohorts (p = 0.11). No significant between-group differences were identified in change in minor thoracic Cobb angle (p = 0.29), coronal balance (p = 0.31), thoracic kyphosis (p = 0.85), lumbar lordosis (p = 0.36), thoracolumbar kyphosis (p = 0.39), or sagittal vertical axis (p = 0.92).
conclusionsIn the published literature on Lenke 5 AIS, PCOs are not routinely utilized during PSF and were not associated with significantly improved coronal or sagittal radiographic correction compared with PSF alone. Current evidence may better support selective case-by-case use of PCOs rather than routine use.
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