Apical Derotation for Deformity Correction in Adolescent Idiopathic Scoliosis Using the Pedicle Screw-plate Spinal System

Abstract

The treatment of adolescent idiopathic scoliosis has evolved substantially over the last few decades. The Cotrel-Dubousste spinal system has demonstrated excellent results in coronal and sagittal deformity correction but remains inferior in rotational deformity control. The evolution of pedicle screws in the modern spinal instrument system allows 3-column fixation and allows true rotational correction of the vertebral body by direct manipulation. However, the screws can cut into the spinal canal, which can cause disastrous consequences. Since 1990, the pedicle screw-plate system has been in the process of development and has been used for the treatment of adolescent idiopathic scoliosis. With our technique, indirect manipulation of the spinal deformity results in gradual curve correction and in apical vertebral derotation as well. Our results have been comparable to those of the direct derotation techniques reported previously. In this article, the surgical planning and surgical technique applied to our pedicle screw-plate system are demonstrated, and the clinical results are presented.