Which Lenke 1A Curves Are at the Greatest Risk for Adding-On... and Why
Cho RH et al. – Understanding the difference between Lenke 1A–L and 1A–R curve types may be helpful in preventing the adding–on phenomena postoperatively. To prevent adding–on in 1A–R curves, the authors recommend fusing distally to 1 level above the neutral vertebra or 1 to 2 levels above the stable vertebra. In 1A–L curves, adding–on may simply be a need to balance some lumbar curve progression in a young, skeletally immature patient.