Direct Vertebral Rotation versus Derotation Technique in Lenke Type 1 Idiopathic Scoliosis

Abstract

Introduction To date, most of scoliosis corrections are made by derotation and translation of the road from the concave side. The coplanar alignment (VCA) technique recovers the normal anatomy of the spine in its three dimensions, correcting rotation, translation, and restoring the surgical outcomes of VCA against derotation maneuver in selective fusions of patients with Lenke 1 idiopathic scoliosis. Patients and Methods Prospective trial of 21 patients with Lenke 1 idiopathic scoliosis. Fusion levels were determined according to Lenke criteria. In group A (10 patients), the VCA was used; and in group B (11 patients), we perform derotation maneuvers. Multiple radiographic variables were analyzed and SRS-22 was also measured. Results Both the groups were similar in terms of preoperative demographic and radiological variables. Coronal Cobb correction rate was 66.5% in group A and 70.06% in group B. There were no differences in postoperative thoracic kyphosis (group A: 29degrees/group B: 30 degrees, p = 0.9438), but we found a significant difference in the correction of apical translation (group A: 14.5 mm vs. group B: 17 mm, p = 0.0069). None of the groups presented vascular or neurological complications. The SRS-22 score improved significantly after 1-year follow-up without differences between the groups. Conclusion In treating Lenke 1 idiopathic scoliosis with selective fusion, both techniques provide good clinical and radiological results. The only advantage of VCA lies in allowing a better correction of apical translation.