The Clinical Significance of the Lowest Instrumented Vertebra in Adolescent Idiopathic Scoliosis

Selecting the lowest instrumented vertebra (LIV) in fusion for adolescent idiopathic scoliosis is potentially the most nuanced decision a surgeon has to make. This article reviews the literature on the range-of-motion loss related to the LIV, ability to return to sports based on LIV, correlation between LIV and disk degeneration, and short-term and long-term clinical outcomes related to LIV.