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

Gang Un Kim, Jae Hyuk Yang, Dong Gune Chang, Se Il Suk, Seung-Woo Suh, Kwang Sup Song, Ki Youl Nam, In Soo Oh, Hyung Youl Park, Sang Il Kim, Young Hoon Kim, Kee Yong Ha

Research output: Contribution to journalArticle

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.

Original languageEnglish
JournalWorld Neurosurgery
DOIs
Publication statusPublished - 2019 Jan 1

Keywords

  • Adding-on
  • Adolescent idiopathic scoliosis
  • Fusion level
  • Pedicle screw instrumentation
  • Selective thoracic fusion
  • Thoracic scoliosis

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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    Kim, G. U., Yang, J. H., Chang, D. G., Suk, S. I., Suh, S-W., Song, K. S., Nam, K. Y., Oh, I. S., Park, H. Y., Kim, S. I., Kim, Y. H., & Ha, K. Y. (2019). Effect of Direct Vertebral Rotation in Single Thoracic Adolescent Idiopathic Scoliosis: Better 3-Dimensional Deformity Correction. World Neurosurgery. https://doi.org/10.1016/j.wneu.2019.05.164