CONTROVERSY FUSION OF L5-S1 IN ADULT SCOLIOSIS

Correction of adult scoliotic deformities often involves long segment fusions into the lower lumbar spine. The risks of late complications f rom excluding L5-S1 from the fusion include subsequent lumbosacral ins tability and pain and must be weighed against the additional risks and complications of routinely including L5-S1 in these long fusions. Dr. Holt and his colleague are emphatic that fusion of L5-S1 should be av oided at all costs; Dr. Horton believes that long-term follow-up resul ts suggest the benefits of including this level may outweigh the added risks and offers a more tempered opinion.