Selective Thoracic Fusion of Lenke I and II Curves Affects Sagittal Profiles But Not Sagittal or Spinopelvic Alignment

Abstract

3.

Effect of Direct Vertebral Rotation on the Spine Parameters (Coronal and Sagittal) in Adolescent Idiopathic Scoliosis

“…The radiographs were centered on T12 during inspiration, with a 2-meter distance between the lm and the focus. All images were transferred to a computer as digital images and evaluated using the image software Surgimap Spine (Nemaris Inc., New York, USA) [4,5,7,9].…”

“…During the surgical correction of adolescent scoliosis, direct vertebral rotation (DVR) in combination with rod derotation after pedicle screw instrumentation enables correction of rotational vertebral body deformity, achieving a su cient correction angle with a reduced fusion level while minimizing aggravated deformity and complications due to patient growth [7,8]. In the late 1990s, the literature showed use of the new method: DVR designed to foster rotational correction [3,4,[7][8][9]. The choice of an inappropriate fusion level may result in under-or overcorrection of major and compensatory curves, in turn potentially causing serious problems such as trunk imbalance and decompensation [10].…”

“…To correct the intervertebral rotation, the direction of DVR should be opposite that of the rotational deformity, i.e., counter-clockwise in the transverse plane [11]. The direction of rod derotation (clockwise rotation) should be opposite that of DVR (counter-clockwise rotation) in the apical and periapical vertebrae of the right thoracic curve [8][9][10]. The direction of DVR in the lowest instrumented vertebra (LIV) and its effect on the uninstrumented curve are still undetermined [4,10,11].…”

“…The authors of recent studies have focused on the radiologic outcomes of DVR in scoliosis surgery [9][10][11][12][13][14]. However, its e cacy and safety remain to be determined.…”

Change of sagittal spinopelvic parameters after selective and non-selective fusion in lenke type 1 adolescent idiopathic scolÝosÝs patÝents

“…Changes in sagittal parameters during the postoperative period can be expected in patients with both selective and non-selective fusion. Ries et al compared the group of 50 Lenke Type 1 and Type 2 patients with 32 healthy individuals and found that both the TK and LL were decreased after selective fusion in each group, whereas SVA and PT were not affected (12). As a result, they showed that, although the sagittal profile was altered; sagittal spinopelvic parameters did especially in the Lenke Type 1; however, sagittal spinopelvic parameters were similar in all Lenke types.…”