JBJS welcomes reader comments on published articles. Letters to the Editor are reviewed by JBJS editors but are not peer-reviewed. To submit your letter, please follow the "submit a response" link that appears in the content box at the upper right of the full text of the article.

Letters to the Editor to:

Article:
Lawrence G. Lenke, Randal R. Betz, Jürgen Harms, Keith H. Bridwell, David H. Clements, Thomas G. Lowe, and Kathy Blanke
Adolescent Idiopathic Scoliosis : A New Classification to Determine Extent of Spinal Arthrodesis
J Bone Joint Surg Am 2001; 83: 1169-1181 [Abstract] [Full text] [PDF]
*Letters to the Editor: Submit a response to this article

Electronic letters published:

[Read Letter to the Editor] Adolescent Idiopathic Scoliosis
ASHRAF A ANBAR   (1 June 2005)

Adolescent Idiopathic Scoliosis 1 June 2005
Top
ASHRAF A ANBAR,
Lecturer of Trauma & Orthopaedics, Cairo University.

Send letter to journal:
Re: Adolescent Idiopathic Scoliosis

ashraf_anbar{at}hotmail.com ASHRAF A ANBAR

To the Editor:

I would like to direct the attention of the authors of this excellent paper to a mistake that may result in confusion to its readers.

On page 1172, the authors defined the curves type 3 and 6 as follows: Type 3—double major: The main thoracic and thoracolumbar/ lumbar curves are structural, while the proximal thoracic curve is nonstructural. The main thoracic curve is the major curve and is greater than, equal to, or no more than 5°less than the Cobb measurement of the thoracolumbar/lumbar curve.

Type 6—thoracolumbar/lumbar-main thoracic: The thoracolumbar/lumbar curve is the major curve and measures at least 5° more than the main thoracic curve, which is structural. The proximal thoracic curve is nonstructural.

Then, on pages 1172 and 1173 they wrote: "If the difference between the lumbar and thoracic curves is <5°, the scoliosis can be categorized as type 3, 4, or 5 on the basis of the structural characteristics of the main thoracic and thoracolumbar/lumbar regions. For the sake of clarity, the major curve (the curve with the largest Cobb measurement) always distinguishes between type 3 (main thoracic curve is major) and type 6 (thoracolumbar/lumbar curve is major). If the Cobb measurements of the main thoracic and thoracolumbar/lumbar curves are equal, then the thoracic curve is considered the major curve. Thus in Figures 4-A through 4-F,the curve classification is type 6."

But by looking at the mentioned figures, I found the lumbar curve (60°) measuring only 3° more than the main thoracic curve (57°), which is according to the authors' definition, excludes type 6 and makes the curve type 3,4 or 5. As long as the proximal thoracic curve is non-structural, the curve is not type 4. On the other hand, because the main thoracic curve is structural, the curve is type 3.