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Analysis of lumbar lordosis in posterior spine fusions for idiopathic scoliosis.

Previous reports are inconclusive regarding changes in the lumbar region after Harrington rod distraction and posterior spinal fusion for idiopathic scoliosis. The purpose of this study was to evaluate the effects of spinal fusion on the lumbar region, particularly the overall lumbar lordosis, the lumbar lordosis in and below the fused segment, the sacro-horizontal angle, and the sagittal plane alignment of the spine. Sixty-six patients under 21 years of age with idiopathic scoliosis who had spine fusion extending to the lumbar vertebrae using only Harrington distraction instrumentation were evaluated. The total lordosis, sacro-horizontal angle, and sagittal plane alignment remained relatively constant. The lordosis within the fusion decreased, and lordosis caudal to the fusion, including the last fused vertebra, increased as the lower hook placement site moved caudally.