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Effect of Direct Vertebral Rotation in Single Thoracic Adolescent Idiopathic Scoliosis: Better 3-Dimensional Deformity Correction.

Abstract：

OBJECTIVE:To analyze the effects of direct vertebral rotation (DVR) on radiologic outcomes in the treatment of thoracic adolescent idiopathic scoliosis after selective thoracic fusion with pedicle screw instrumentation. METHODS:Adolescent idiopathic scoliosis patients with single thoracic curves (n = 110) treated by selective thoracic fusion with a minimum of 2 years of follow-up were retrospectively analyzed. The patients were separated into 2 groups: non-DVR (n = 63) and DVR (n = 47). RESULTS:There was a significant difference in fused segments between the non-DVR and DVR groups (P < 0.001). There was also a significant difference in main thoracic curve postoperatively (P = 0.001) and at the last follow-up (P = 0.006) between the non-DVR and DVR groups. However, there was no significant difference in proximal thoracic and lumbar curves postoperatively (proximal thoracic curve: P = 0.186; lumbar curve: P = 0.155) and at the last follow-up (proximal thoracic curve: P = 0.250; lumbar curve: P = 0.060) between the 2 groups. Significant improvements in the lowest instrumented vertebra tilt and disc angle were noted but then slight deteriorations in such were observed during the follow-up period in the non-DVR group. The prevalence of unsatisfactory results was 20.6% (13 of 63) in the non-DVR group and 19.1% (9 of 47) in the DVR group, with no significant difference (P = 0.522). CONCLUSIONS:For correcting single thoracic adolescent idiopathic scoliosis by selective thoracic fusion with pedicle screw instrumentation, the addition of DVR to the surgical procedure showed comparable radiologic outcomes compared with non-DVR procedures.

journal_name

World Neurosurg

journal_title

World neurosurgery

authors

Kim GU,Yang JH,Chang DG,Suk SI,Suh SW,Song KS,Nam KY,Oh IS,Park HY,Kim SI,Kim YH,Ha KY

doi

10.1016/j.wneu.2019.05.164

subject

Has Abstract

pub_date

2019-09-01 00:00:00

pages

e401-e408

eissn

1878-8750

issn

1878-8769

pii

S1878-8750(19)31441-X

journal_volume

129

pub_type

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