Vertebral Coplanar Alignment

Vallespir, Gabriel Pizà; Flores, Jesús Burgos; Trigueros, Ignacio Sanpera; Sierra, Eduardo Hevia; Fernández, Pedro Doménech; Olaverri, Juan Carlos Rodríguez; Alonso, Manuel García; Galea, Rafael Ramos; Francisco, Antonio Pérez; Paz, Beatriz Rodríguez de; Carbonell, Pilar; Thomas, Javier Vicente; López, José Luis González; Paulino, José Ignacio Maruenda; Pitarque, Carlos Barrios; García, Óscar

doi:10.1097/brs.0b013e3181788704

Cited by 53 publications

(26 citation statements)

References 35 publications

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“…Bilateral apical vertebral derotation by vertebral column manipulation (VCM) was introduced by Chang and Lenke [13] using a “quadrilateral frame” to bilaterally simultaneously manipulate the spine, thereby effectively correcting 3D deformities present in IS. Vertebral coplanar alignment (VCA) was described by Vallespir [14] who utilized the coplanar nature of the x - and z- axes of the spine to correct translation and rotation in patients with scoliosis. Clinical studies have demonstrated the effectiveness of 3D correction for IS using VCA [14,15].…”

Section: Introductionmentioning

confidence: 99%

“…Vertebral coplanar alignment (VCA) was described by Vallespir [14] who utilized the coplanar nature of the x - and z- axes of the spine to correct translation and rotation in patients with scoliosis. Clinical studies have demonstrated the effectiveness of 3D correction for IS using VCA [14,15]. However, few reports to date have compared the bilateral apical vertebral derotation technique by VCM to the VCA technique as assessed by radiographic, functional, and outcome parameters, and technical features in patients with IS.…”

Section: Introductionmentioning

confidence: 99%

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Bilateral apical vertebral derotation technique by vertebral column manipulation compared with vertebral coplanar alignment technique in the correction of lenke type 1 idiopathic scoliosis

Sun

Song

Liu

et al. 2013

BMC Musculoskelet Disord

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BackgroundWidely used rod rotation and translation techniques for idiopathic scoliosis (IS) are effective in correcting spinal coronal deformity. Bilateral apical vertebral derotation technique by vertebral column manipulation (VCM) and vertebral coplanar alignment (VCA) technique are two strategies for three-dimensional (3D) correction for IS. The purpose of this study is to compare the post-surgical results and technical features of the bilateral apical vertebral derotation technique by VCM against the VCA technique in patients with Lenke type 1 IS.MethodsForty-eight patients with Lenke type 1 IS were enrolled in the present prospective clinical assay. They were divided into groups A (bilateral apical vertebral derotation technique by VCM, n=24) and B (VCA technique, n=24). Radiographic parameters measured before and after surgery included the Cobb angle, thoracic kyphosis, and apical vertebral rotation. Scoliosis Research Society (SRS)-22 scores were evaluated during the final follow-up. The differences in the demographics, surgical details, and radiographic measurements between the two groups were determined using a T test. The Mann–Whitney U test was used to evaluate the differences in the SRS-22 scores. A value of P<0.05 was considered statistically significant.ResultsIn the coronal plane, a significant difference was found in the correction rate of the major curve (group A: 84.8%, group B: 78.4%; P=0.045) and in the Cincinnati Correction Index between two groups (group A: 2.21, group B: 1.98; P=0.047). In the sagittal plane, no difference was found in the postoperative thoracic kyphosis between the two groups (P=0.328). In the transverse plane, no difference was found between the two groups in the correction rates of the rotation angle sagittal (P=0.298), rib hump (P=0.934), apical vertebral body-to-rib ratio (P=0.988), or apical rib spread difference (P=0.184). Patients underwent follow up for an average of 21.9 and 22.2 months in groups A and B, respectively. Results obtained at the final follow-up indicated no significant loss of correction. No differences were found in the SRS-22 scores between the two groups. No aortic or neurological complications were observed.ConclusionsThe 3D deformity of the spine was effectively corrected using the bilateral apical vertebral derotation technique by VCM and the VCA technique, and encouraging post-surgical results were obtained for patients with Lenke type 1 IS. The two techniques were effective in allowing 3D correctional force that was applied in different ways.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Bilateral apical vertebral derotation technique by vertebral column manipulation compared with vertebral coplanar alignment technique in the correction of lenke type 1 idiopathic scoliosis

Sun

Song

Liu

et al. 2013

BMC Musculoskelet Disord

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“…However, previous studies have also shown that PS constructs produce a significantly better vertebral derotation effect than hook-and-rod constructs [5,6,17]. The mean derotation angle obtained with a PS construct is reported to be 7.1-13.0° [5,18,19], while it is 0.4°-3.6° [20-26] with a hook-and-rod construct and 1.9°- 4.2° with the sublaminar wiring technique [27,28]. We therefore hypothesized that the decrease in thoracic kyphosis after posterior correction surgery using PS constructs was associated with the correction of vertebral rotation.…”

Section: Introductionmentioning

confidence: 99%

Vertebral derotation in adolescent idiopathic scoliosis causes hypokyphosis of the thoracic spine

Watanabe

Nakamura²,

Iwanami

et al. 2012

BMC Musculoskelet Disord

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BackgroundThe purpose of this study was to test the hypothesis that direct vertebral derotation by pedicle screws (PS) causes hypokyphosis of the thoracic spine in adolescent idiopathic scoliosis (AIS) patients, using computer simulation.MethodsTwenty AIS patients with Lenke type 1 or 2 who underwent posterior correction surgeries using PS were included in this study. Simulated corrections of each patient’s scoliosis, as determined by the preoperative CT scan data, were performed on segmented 3D models of the whole spine. Two types of simulated extreme correction were performed: 1) complete coronal correction only (C method) and 2) complete coronal correction with complete derotation of vertebral bodies (C + D method). The kyphosis angle (T5-T12) and vertebral rotation angle at the apex were measured before and after the simulated corrections.ResultsThe mean kyphosis angle after the C + D method was significantly smaller than that after the C method (2.7 ± 10.0° vs. 15.0 ± 7.1°, p < 0.01). The mean preoperative apical rotation angle of 15.2 ± 5.5° was completely corrected after the C + D method (0°) and was unchanged after the C method (17.6 ± 4.2°).ConclusionsIn the 3D simulation study, kyphosis was reduced after complete correction of the coronal and rotational deformity, but it was maintained after the coronal-only correction. These results proved the hypothesis that the vertebral derotation obtained by PS causes hypokyphosis of the thoracic spine.

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“…Vellespir et al 13 has shown a curve correction of 73% in their thoracic curves and 70% in thoracolumbar curves with the technique of vertebral coplanar alignment. The latter technique involves vertical slotted tubes attached to the convex screws and longitudinal rod is put in gradually to the convex side so that the rotated vertebrae all come in one plane.…”

Section: Discussionmentioning

confidence: 99%

Posterior scoliosis correction for adolescent idiopathic scoliosis using side-opening pedicle screw-rod system utilizing the axial translation technique

Basu¹,

Rathinavelu²,

Baid³

2010

IJOO

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Background:Though adequate literature is present depicting the results of pedicle screw-rod instrumentation using top loading systems for correction of adolescent idiopathic scoliosis (AIS), using the rod rotation technique, few published data is available regarding side loading systems used for a similar purpose. We report a retrospective study of a cohort of patients with strict inclusion criteria who underwent surgical correction of AIS with side-opening pedicle screw-rod posterior instrumentation using the axial translation technique of curve correction to assess the efficacy of side opening system for scoliosis correction with regards to patient satisfaction, Cobb's angle correction and spinal balance.Materials and Methods:Clinical and radiological outcomes were measured in 14 consecutive patients (3 males, 11 females) with an average age of 14.0 years (range 9 to 23 years). They were followed up for an average period of 13.0 months (range – 2.2 to 28.5). All patients underwent posterior instrumentation only with pedicle screws used as anchor points. Hybrid constructs using hooks/wires or curves requiring anterior release were excluded from the study. All levels were not instrumented – more screws were put on the concavity and in the peri-apical region. Radiological evaluation was done by whole spine standing AP, lateral radiograms preoperatively and 1, 3, 6 and12 months after surgery. Cobb's angles were measured and the spinal balance was noted. Clinical evaluation was done by SRS questionnaire. The complications were documented.Results:The mean preoperative Cobb's angle was 58.35° (range – 44 to 72°), which came down postoperatively to 23.45° (range – 10 to 38°) signifying a mean correction of 59.57% (range – 26.92 to 76.17%). Clinical outcomes were evaluated using the SRS – 30 questionnaires. The values of mean pre- and postoperative scores are 3.68 and 4.18, showing an improvement of 0.5 points. Other than one patient of superficial wound infection, which healed with antibiotics, there was no major complication. No patient had neurological deterioration.Conclusion:Side-opening spinal instrumentation systems, using the axial translation technique, achieved good clinical and radiological outcome for patients of AIS.

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Vertebral Coplanar Alignment

Abstract: VCA provided excellent correction of coronal and transverse planes with normalization of thoracic kyphosis in Lenke type 1 adolescent idiopathic scoliosis surgery.

Cited by 53 publications

References 35 publications

Bilateral apical vertebral derotation technique by vertebral column manipulation compared with vertebral coplanar alignment technique in the correction of lenke type 1 idiopathic scoliosis

Bilateral apical vertebral derotation technique by vertebral column manipulation compared with vertebral coplanar alignment technique in the correction of lenke type 1 idiopathic scoliosis

Vertebral derotation in adolescent idiopathic scoliosis causes hypokyphosis of the thoracic spine

Posterior scoliosis correction for adolescent idiopathic scoliosis using side-opening pedicle screw-rod system utilizing the axial translation technique

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