The Thoracolumbar curve is longer than most and extends from the upper to the lower spine. It may curve either to the right or the left.
Small curves above and below accompany this long curve. Although thoracolumbar curves usually cause minor deformities, they can result in severe rib and trunk distortion. This curve is uncommon.
Also quite common pattern in Idiopathic Scoliosis, 80% occur on the right side.
For type 5 TL/L curves, the general rule is to fuse only the TL/L region, either anteriorly or posteriorly, or, rarely, circumferentially, if required. Anteriorly, the fusion levels will usually be the upper end vertebra, and posteriorly from either the upper end vertebra or one above that to the lower end vertebra or one below that.
Traditionally, these curves have been treated with a selective similar corrections for these curves being obtained through a posterior-only appraoch, as recently reported by Shufflebarger and associates. Rarely, both the MT and TL/L regions require fusion, especially if the shoulder balance requires correction of the MT curve, or the thoracic rib hump is such that inclusion of the MT curve would be required, especially in highly skeletally immature patients with significant growth remaining.
Scoliosis Thoracolumbar Curve